Food allergies are present in 15 million people in the US, and are in as many as 1 in 13 children. The most common allergenic foods in children include milk, egg, peanuts, tree nuts, soy, wheat, and fish.
University of Louisville allergist Gerald Lee, M.D. is among the pediatricians who advise parents to avoid these foods during pregnancy, breast feeding or when introducing solid foods. But there is inconclusive evidence on whether there is a right or wrong way to introduce possible allergens to babies and young children.
Some study results:
Avoiding allergenic foods during pregnancy and breast feeding may help with eczema, but no study has shown a protective role for food allergy. There are some concerns that elimination diets may affect mother and child nutrition.
Breastfeeding exclusively until age six months may have a protective role for asthma and eczema but has not consistently shown protection against food allergy. However, breastfeeding has multiple other benefits and is endorsed by the American Academy of Pediatrics (AAP).
Introducing 4 or more solid foods in the first 4 months may increase allergic diseases, although did not increase risk of food allergy.
In a study of 8600 school children, it was found that Jewish children in the UK had a 10 fold risk of developing peanut allergy that those residing in Israel (1.85% vs. 0.17%) while other rates of egg and milk allergy were similar.
The major difference between infants in Israel vs. the UK were that in Israel, infants are exposed to a peanut puff snack called Bamba during weaning and afterwards eat peanut in greater amounts than UK infants.
Therefore, in the UK, the LEAP study (Learning Early About Peanut allergy) will compare avoidance vs. early introduction of peanut on high risk infants to see if this will reduce peanut allergies at age 5.
Results of this study are expected next year.
What Dr. Lee tells his patients:
Follow the AAP recommendations of exclusive breastfeeding for the first 6 months of age and introducing solid foods at this time.
Eliminating certain foods can help with eczema but not prevent food allergy, and may hamper good nutrition so please only do so under supervision with a doctor.
Next year, we will learn if early introduction of peanut to infants can be a strategy to help infants at risk for peanut allergy.