INTRODUCING HIGHLY ALLERGENIC FOODS TO INFANTS AND CHILDREN

Studies support the existence of a critical time early in infancy during which the genetically predisposed atopic infant is at higher risk for developing allergic sensitization. Thus, dietary interventions in the first years of life have been analyzed for their effects on the prevalence of allergic disease including food allergy. Both American and European allergy expert committee guidelines recommend that solid foods be introduced between four to six months of age in all infants. Other organizations have also concluded that complementary foods may be safely introduced between four and six months of age, although many still recommend or prefer exclusive breastfeeding for the first six months of life. Recommendations regarding when to introduce highly allergenic foods, particularly in high-risk infants, have shifted over time.

While any food has the potential to cause allergy, certain foods are more common triggers of significant acute allergic reactions due to various factors. The most common food allergens in children in the United States and many other countries include cow's milk (CM), hen's egg, soy, wheat, peanut, tree nuts, and seafood. The American Academy of Pediatrics (AAP) had previously suggested in 2000 that the introduction of certain highly allergenic foods be delayed further in high-risk children: cow's milk (CM) until age one year; eggs until age two years; and peanuts, tree nuts, and fish until age three years. This recommendation was based upon early studies that suggested that delayed introduction of solid foods might help prevent some allergic diseases, particularly atopic dermatitis.

The most prevalent allergic or atopic disorders include atopic dermatitis (AD), asthma, Allergic Rhinitis (AR), and food allergies. These conditions afflict 20 percent of the population of the United States, and their prevalence appears to be increasing in developed nations. The increase in atopic diseases has been recognized as a pandemic, thus emphasizing the need for effective allergy prevention.