Updated allergen guidance issued from ASCIA

Parents should introduce eggs and peanuts into babies diets before twelve months, updated guidelines from the Australasian Society of Clinical Immunology and Allergy (ASCIA) have said. The updated guidelines will be of interest to early childhood education and care (ECEC) settings caring for children under twelve months of age.

The main recommendations of the updated guidelines are:

• When the infant is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods. (This is not a strict window of introduction but rather a recommendation not to delay the introduction of solid foods beyond 12 months.)

• Introduce peanut and egg in the first year of life in all infants, regardless of their allergy risk factors.

• Hydrolysed (also known as hypoallergenic) formula is no longer recommended for the prevention of allergic disease.

Once “new” foods have been introduced, the guidelines say, they should be given to children twice weekly to ensure tolerance to the food is not lost. The recommendations are outlined in the latest Medical Journal of Australia.

The Courier Mail quotes lead author of the guidelines, Dr Preeti Joshi, as saying food allergy rates in Australia are amongst the highest in the world. One in ten babies have a proven food allergy before their first birthday, with allergies to egg, milk, wheat, soy, peanuts, tree nuts, fish, and shellfish being the most common.

Previous guidelines have recommended that certain allergens are avoided in early childhood, however Dr Joshi said that there was “moderate evidence” that regular peanut intake before twelve months of age could in fact reduce the risk of children developing allergies.

Dr Joshi recommended that parents introduce new foods to their baby under guidance from a medical professional if the child had existing proven allergies or severe eczema. The updated guidelines emphasise that if a child has an allergic reaction to peanuts at any stage, parents should seek medical advice.

“We acknowledge that there is a cultural fear of peanut introduction,” Dr Joshi wrote. “This does need to be balanced by a practical approach whereby infants have access to introduction of peanut in a timely fashion.”

“It is somewhat reassuring that there have been no reports of fatalities to peanut under 12 months of age anywhere in the world, even in countries that have practised early introduction of peanut, for example Israel, for many years.” Dr Joshi said.