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Early Exposure to Foods Reduces Risk of Developing Food Allergies

Well, it looks like the medical advice for avoiding food allergies in children has come full circle. For decades health professionals said for babies to avoid eating problem foods (e.g., eggs, dairy, peanuts) if parents have food allergies. But..it turned out that following this advice did not prevent food allergies.

Results of studies in the past decade changed medical views regarding food allergies. Now the advice is: Early exposure (in the first year of life) to foods such as eggs, milk, peanut butter, and wheat is preventive - don't avoid.

A recent well done Scandinavian study confirmed that this advice is good for all young children, not just those with a family history of food allergies. Starting at 3 months of age, infants who regularly ate tiny amounts of foods (wheat, eggs, cow's milk, peanuts) had a lower chance of food allergies by 3 years of age.

Only .9% of these children developed food allergies, while 2.3% to 3% of children not getting early exposure to foods developed egg, dairy, or peanut allergies.

Also, in this study some infants had their skin rubbed with skin emollients, bath additives and facial cream from 2 weeks to 8 months, 4 times per week, and more of them developed food allergies - whether also avoiding foods or not. [My comment: Why would anyone think that would help with food allergies? It sounds irritating! And it perhaps/probably messed with their skin microbiome.]

New advice: Infants should have early exposure to potentially problem foods, starting as early as 3 months, to lower their risk of developing food allergies. Delaying the introduction of these foods actually increases the risk of food allergies. (By the way, the same advice also holds true for avoiding pet allergies - exposure to furry pets in the first year of life is important.)

From Medical Xpress: Early food introduction can reduce risk of food allergy in children

Infants who were given a taste of peanut, milk, wheat and egg from the age of three months had a lower risk of developing a food allergy at the age of three years than controls, reports a study by researchers from Karolinska Institutet in Sweden and the University of Oslo in Norway published in The Lancet.

Food allergies that can cause anywhere from mild to acute, life-threatening allergic reactions affect 2–5 percent of all children. Some studies have indicated that early introduction of allergenic foods, such as peanuts and egg, can reduce the risk of food allergies in susceptible children. However, evidence that it could be effective in children in general has been lacking.

Working under the PreventADALL study, researchers at Karolinska Institutet, the University of Oslo, Karolinska University Hospital in Stockholm (Sweden), Oslo University Hospital and Östfold Hospital Trust (Norway), have now examined if the risk of food allergy at the age of three years can be mitigated if children are given regular small portions of food containing peanut, milk and egg from the age of three months.

The results show that children who received early tastes had a 1.1 percent risk of developing an allergic reaction to one of the introduced foods by the age of three, compared to a 2.6 percent risk among children who did not have early food introduction. This means that 63 children need to be exposed to early introduction of allergenic foods to prevent food allergies in one child.

Reduced risk of peanut allergy

The main contributing factor was the reduced risk of peanut allergy, the most common allergy in the study, which was 0.7 percent in the intervention group compared to 2.0 percent in the control group.

"This is a significant protective effect given that it involves a simple remedy," says Björn Nordlund, research group leader at the Department of Women's and Children's Health, Karolinska Institutet, and specialist nurse at the Astrid Lindgren Children's Hospital, where the Swedish part of the study was conducted. "Early introduction clearly reduced the risk of peanut allergy, an allergy that lasts a lifetime and that can cause serious reactions and anxiety that often impacts on quality of life."

The study included 2,397 children from Norway and Sweden, who were randomly assigned to one of four treatment groups. In a previously reported part of the study, the researchers examined the effect of regular emollients from two weeks of age and/or early food introduction on atopic eczema, which is a risk factor for later food allergies.

One group received food introduction in the form of regular small portions of peanut butter, milk, wheat or cooked egg from the age of three months; a second group received the same plus moisturizing skin emollients; a third was given only the skin emollients; and a fourth received no specific treatment. All parents were urged to follow the national food introduction guidelines.

Very small amounts

Peanut was introduced first, followed a week later by cow's milk, then wheat porridge and egg. The parents were instructed to let their child taste the food at least four days a week alongside his or her regular nutrition, and then encouraged to continue giving the four foods as part of the child's regular diet after the age of six months.

"We're talking small amounts—a baby sucking a finger coated with peanut butter, say, or having a taste from a teaspoon," explains Dr. Nordlund.

Over 80 percent of the infants attended follow-up until the age of three, at which point the presence of an allergy to one of the four foods was examined. Food allergies were diagnosed in 44 of the infants: 32 with peanut allergy, 12 with egg allergy and four with milk allergy.

Food allergy was diagnosed in 14 (2.3 percent) of 596 infants in the non-intervention group, 17 (3.0 percent) of 574 infants in the skin intervention group, six (0.9 percent) of 641 infants in the food intervention group, and seven (1.2 percent) of 583 infants in the combined intervention group. Since the prevalence of other allergies than to peanuts was low at three years, the study is unable to ascertain the effect on the allergy risk associated with all the individual foods.

Did not seem to affect breastfeeding

The Swedish National Food Agency's advice on infant feeding suggests letting babies taste regular food from no earlier than the age of four months, as long as the amounts are small enough not to compete with breast feeding. The earlier introduction in the study does not seem to have affected breastfeeding—around 90 percent of the babies in all groups were still being breast fed by the age of six months.

The study identified no safety problems, and no serious allergic reactions caused by the early introduction were observed.

Early and regular introduction

The researchers say that their results support the hypothesis that the early and regular introduction of allergenic foods, rather than later introduction or avoidance, can reduce the risk of food allergies.

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