Some parents took note early this year when the American Academy of Allergy, Asthma & Immunology (AAAAI) stated that highly allergenic foods such as peanut butter, fish and eggs can be introduced to babies between four and six months and may even play a role in preventing food allergies from developing. For some, it seemed to be an “about face” from a 2000 recommendation from the American Academy of Pediatrics (AAP).
We spoke with Dr. Steve Taylor, professor in the Department of Food Science and Technology at the University of Nebraska, and learned the new recommendation isn’t really new.
Dr. Steve Taylor
Dr. Taylor: “The AAP changed its recommendation in 2008 and now AAAAI and AAP are basically in agreement. The AAP now recognizes that the recommendation to withhold solid food from the diets of infants was not evidence-based. It seemed logical, but it wasn’t based on solid clinical studies.
“We also knew by 2008 that if you followed the 2000 recommendation it didn’t seem to make any difference in the likelihood that your child would end up with a food allergy. Both groups recommend exclusive breast feeding for six months and no restriction on the use of solid foods beyond six months. They don’t say you should introduce solid foods that early. They just don’t say you shouldn’t.
“The AAAAI indicates that it may be OK to introduce solid foods as young as four months, so if there’s a difference, it’s just those two months.”
You mentioned clinical studies. Are these latest recommendations based on study?
Dr. Taylor: “There’s a big study going on right now that will either make me jump completely on the bandwagon for these latest recommendations or completely jump off of it. It’s called the LEAP Study (Learning Early About Peanuts) and it’s taking place in England. It involves two groups of infants. One is exposed to peanuts as early as 4 months. The other group is following the old British recommendation of avoiding peanuts for the first two or three years of life.
“When it’s done, they’ll be able to see what the comparative prevalence of peanut allergy is and whether exposure to peanuts at 4 months is protective.
“It all began with an observation that there was a relatively high prevalence of peanut allergies among Jewish children in London but the prevalence of peanut allergy among children in Israel was extremely low – less than one-tenth of one percent.
“The children in those two settings had very similar genetic backgrounds – they all came from displaced Eastern Europeans during World War II.
“It seems the most popular weaning food in Israel is a snack-like food called Bamba. They’re similar to Cheetohs but contain peanut butter instead of cheese. Mothers in Israel begin letting their babies gum on Bamba snacks as early as 4 months of age and Israel has an incredibly low prevalence of peanut allergies.
“This doesn’t necessarily prove anything but it’s certainly an interesting observation. Now they’re trying to prove it. The results will probably be out in about 18 months.”
The prevalence of food allergies in children under 18 years old increased 18 percent between 1997 and 2007. Are there theories why?
Dr. Taylor: “There are some theories surrounding weaning practices. I don’t think anybody is against breast feeding but whether it should be completely exclusive is perhaps an issue.
“There is a hygiene hypothesis that we are so clean now that our immune system doesn’t have anything to react to so we get food allergies instead. There’s some evidence for this by comparing urban and rural populations. Rural kids have less food allergies and they probably get exposed to more hygiene challenges out in the country than urban kids.
“There’s a reasonable amount of evidence that babies born by Cesarean section are much more likely to acquire food allergies than babies born naturally. C-section babies are born with sterile GI tracts which might be a factor in leading them to a higher rate of food allergy development.
“There’s also a nutritional theory that Vitamin D might be protective and the observation has been made that kids born in the winter months when there’s less sunlight exposure tend to have somewhat higher levels of food allergies than kids born in the spring and summer.
“I believe the overall increase is multi-factorial. There are probably reasons to believe all of these factors and maybe some others are contributing to the increase. “
When it comes to your questions about the food you eat, who do you trust the most?