There is no convincing evidence that delaying the introduction of allergenic foods beyond 4 to 6 months of age works in preventing food allergies, according to an updated guidance of the American Academy of Pediatrics.  Moreover,  there is now evidence that early introduction of peanuts may prevent peanut allergy.

What is new?

The new guidelines continue to liberalize the introduction of what are thought to be highly allergenic foods such as peanuts, fish and milk.

There is no reason to delay giving your baby foods that are thought of as allergens like peanut products, eggs or fish," Dr. Scott Sicherer, a co-author of the report, said in a statement. "These foods can be added to the diet early, just like foods that are not common allergens, like rice, fruits or vegetables."

In 2000, the American Academy of Pediatrics recommended delaying the introduction of cow's milk until children were 1 year old, egg until 2 years and peanuts, tree nuts and fish until 3 years, CNN reports. The arguments for this then were - if we avoid any exposure, maybe the allergic response won't develop, explains Dr. David Stukus, a pediatric allergist and associate professor of pediatrics in the Division of Allergy and Immunology at Nationwide Children's Hospital. 

In 2008, after a review of the available literature, the organization issued a report saying there was no convincing evidence that delaying allergenic food introduction prevented food allergies. 

A critical window of timefo introduction of new foods

The latest report explains that the same mechanism that protects infants at high risk is likely to protect infants at low or standard risk of developing food allergies.

The gastrointestinal tract is home to a unique set of immune system cells, and when these cells are given a taste of the allergenic proteins in different foods, they take up these proteins and become tolerant to them. Dr. David Stukus. He said that's true as long as it's introduced early and in an ongoing fashion, meaning there is a critical window of time during which being introduced to these foodsmay lead the body to become tolerant.

Breastfeeding and food allergies

The report also looked at whether breastfeeding protects against eczema, wheezing, asthma and food allergies.

As with the previous report, the available data still limit the ability to draw firm conclusions about  atopy prevention through early dietary interventions. Current evidence does not support a role for maternal dietary restrictions during pregnancy or lactation. 

There is evidence that exclusive breastfeeding for 3 to 4 months decreases the incidence of eczema in the first 2 years of life,  but there are no short- or long-term advantages for exclusive breastfeeding beyond 3 to 4 months for prevention of atopic disease, the authors conclude. 

Any amount of breastfeeding beyond that time, even if not exclusive, was found to be protective against wheezing in the first two years of life and asthma in the first five years and even later. The report says no conclusion could be made when it came to breastfeeding and its effect on the prevention of food allergies. There is a lack of evidence that partially or extensively hydrolyzed formula prevents atopic diseaseq the report says.

Read the whole report HERE