Guidelines on infant feeding must be urgently changed
Anyone who has seen me with a new baby or read my work would be aware that I am a strong advocate for starting solids early. My experience is that there are benefits for mother and child. One of these benefits is lowered risks of food allergy.
There have been increasingly robust studies in recent years showing that a delay in starting solids would increase the risk of food allergy.
In February 2015, a major study was published in the New England Journal of Medicine looking at the impact of early exposure to peanuts. The study found that the introduction of peanut between 4-11 months decreased the risk of peanut allergy by between 70% and 80%.
Peanut allergy is the leading cause of anaphylaxis and death related to food allergy in the United States . The randomised controlled trial (RCT) published in February provides guidance about the best time to introduce peanut-based products – that is, in this study, at least 4-11 months of age.
There are more than 300,000 babies born in Australia each year . In Australian children, the risk of developing peanut allergy at the moment is about 3%. Statistically, that means there could be as many as 9,000 children each year who develop a peanut allergy. The results of this study indicate that in 70-80% of those cases (say 7,000 children per annum), the allergy could have been prevented with the early introduction of peanut-based product.
The significance of this trial – which, in my opinion, now takes the body of evidence supporting the early introduction of solids beyond refute – is that the guidelines on infant feeding must be urgently changed in order to prevent the unnecessary risk of peanut allergy in children.
It is no longer sound advice to tell parents to avoid introducing a range of healthy foods to infants at an early age. Quite the opposite, to not introduce foods earlier might be contributing to a food allergy that, in the case of peanuts, is life-long and can be fatal.
It is likely these findings will also inform future guidelines about the best time to introduce other allergenic foods such as milk, egg and tree nuts.
The study, known as the Learning Early about Peanut Allergy (LEAP), was conducted by group of researchers from universities in the United Kingdom and the United States of America. It used randomised trial methodology, meaning it provides the “highest level of evidence” to establish its findings. The findings were published in The New England Journal of Medicine on 26 February 2015. Read the editorial here (9328 KB) or the full research paper here (2MB).
Dr Brian Symon
The Babysleep Doctor Sampson HA. Peanut allergy. N Engl J Med 2002;346: 1294-9.  www.aifs.gov.au/institute/info/charts/births.