New guidelines for preventing pediatric food allergies

Dealing with food allergies is difficult for people at any age, but it is especially difficult for young children. They may not understand why they cannot eat the same foods as their friends and can struggle with feeling different than the people around them. Most food allergies are developed and identified during childhood. Now, there is an opportunity for parents to play a role in preventing food allergies in their children.

Food allergy facts

A potentially allergenic food is one that may cause an allergic response when eaten. Any food can cause an allergic response, however, in the United States we have the “Big 8” potentially allergenic foods. These are peanuts, tree nuts, soy, milk, wheat, egg, fish, and shellfish.^1-3

Food allergies are driven by an immune reaction. When the allergenic food is consumed, the body triggers an immune response, often led by immunoglobulin E (IgE).^1-3 Symptoms of a food allergy vary between individuals, but often include hives, swelling, difficulty breathing, or GI upset.^1-3 The same reaction is triggered every time the food is consumed, no matter the amount.

There are multiple factors associated with the development of food allergies. These include genes, environment, and presence of other types of allergies. Environment is one area that parents can actually influence.

New recommendations for food allergies

In the past, experts have recommended avoiding potentially allergenic foods until a child was older to prevent an allergy.^4-6 New recommendations are emerging that may be a game changer.

Evidence now suggests that food allergies are diagnosed less frequently in children whose parents exposed them to potentially allergenic foods early in life and continued to provide those foods throughout early childhood.⁷ The “Big 8” allergenic foods are generally targeted under these recommendations.

How early should parents consider introducing these foods? Generally, parents can begin this process when their child is between the ages of 6 months and 1 year old.⁷ This may seem too young, but this is the age when children should be experiencing a wide variety of new foods. But the process doesn’t stop there—once these foods are introduced, they should continue to be included in the child’s diet to reap the full protective effect.⁷

Parents and parents-to-be should consider discussing these recommendations with their pediatrician and registered dietitian.

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References

Waserman, S., Bégin, P. & Watson, W. (2018).  IgE-mediated food allergy. Allergy Asthma Clin Immunol 14, 55. Retrieved from https://doi.org/10.1186/s13223-018-0284-3

American Academy of Allergy Asthma & Immunology (AAAA&I). (2019). Food Allergy. Retrieved from https://www.aaaai.org/conditions-and-treatments/allergies/food-allergies

American Academy of Allergy Asthma & Immunology (AAAA&I). (2019). Immunoglobulin E (IgE) Definition. Retrieved from https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/immunoglobulin-e-(ige)

Chan, E.S., Abrams, E.M., Hildebrand, K.J. Watson, W. (2018). Early introduction of foods to prevent food allergy. Allergy Asthma Clin Immunol,14(Suppl 2), 57 https://doi.org/10.1186/s13223-018-0286-1

Greer, F. R., Sicherer, S. H., Burks, A. W., (2019). Committee on Nutrition, Section on Allergy and Immunology: The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods. Pediatrics. 143(4): Retrieved from: https://pediatrics.aappublications.org/content/143/4/e20190281#sec-9

Collins, S. C., (2016). Practice Paper of the Academy of Nutrition and Dietetics: Role of the Registered Dietitian Nutritionist in the Diagnosis and Management of Food Allergies. Journal of the Academy of Nutrition and Dietetics 116: 10. Retrieved from: https://jandonline.org/action/showPdf?pii=S2212-2672%2816%2930935-2

American Academy of Asthma Allergy & Immunology (AAAA&I). (2020). Preventing Food Allergies & Asthma In Children. Retrieved from: https://www.aaaai.org/conditions-and-treatments/library/allergy-library/prevention-of-allergies-and-asthma-in-children