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Infant feeding and allergy prevention

1 Jun 2009 9:31 PM - Dr Roger Morris

Review of recent research papers and position statements in the area of infant feeding and allergy prevention has resulted in Australia’s peak professional body of specialist allergists and immunologists (ASCIA) to revise and update its official advice regarding infant feeding. The Australian Society of Clinical Immunology and Allergy (ASCIA) states that the reasons for the continued rise in allergic diseases are complex and not well understood. Many previous strategies have been shown to be ineffective in the prevention of serious childhood allergy. Although children with a family history of allergy are at a higher risk of allergy, many children with no family history also develop allergy. The current advice regarding infant feeding is relevant for all families and takes into account current evidence to the end of 2008.

The key points of the revised advice from ASCIA are:

1. Breastfeeding

  • Breastfeeding is recommended for at least the first 6 months of life and is encouraged for as long as the mother and infant wish to continue.
  • Breastfeeding during the period that foods are first introduced may help prevent the development of allergy to those foods.
  • Exclusion of allergenic foods from the maternal diet has not been shown to prevent allergies.
  • If infant formula is introduced in the first months of life before solid foods, the use of hydrolysed cow’s milk formulas (usually labeled ‘HA’ for ‘hypoallergenic’) may reduce the risk of allergy in high risk infants. Soy milk and other mammalian milks such as goat are not recommended for allergy prevention.

2. Introduction of Solid Foods

Based on current evidence, it is still considered safe to introduce complementary solid foods from the age of 4-6 months, depending on the developmental receptiveness of the child.

  • There is little evidence that delaying the introduction of solid foods beyond 6 months reduces the risk of allergy.
  • It is possible that delaying introduction of foods may actually increase (rather than decrease) allergy. More research is required in this area.
  • There is insufficient evidence currently to support advice to specifically delay or avoid potentially allergenic foods (such as eggs, peanuts, nuts, wheat, cow’s milk or fish). This also applies to infants with siblings who already have allergies to these foods.
  • Breast milk or infant formula should remain the main source of milk until 12 months of age, although cow’s milk can be used in cooking or with other foods such as yoghurt, custard and cheese.

In general, current evidence suggests that there are no particular allergenic foods that should be avoided. If your child shows any evidence of allergy reactions or if you are uncertain about this advice, you should discuss this with your doctor.