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Health

Giving babies eggs and nut products early may avert allergies

Introducing taste of peanuts and eggs at an early age lowers the risk that children will develop these allergies, new review suggests.

Timing of gluten introduction didn't have any impact on whether kids developed celiac disease

The review adds to a growing body of evidence suggesting that early introduction of eggs and peanuts can help some children develop a tolerance to these foods who would otherwise be allergic. (Jim Cole/Associated Press)
Infants who get a taste of eggs andpeanuts starting when they're as young as 4 months old may havea lower risk of developing allergies to those foods than babieswho try them later, a research review suggests.

These findings suggest that for most babies, eggs andpeanuts should be among their first foods, said seniorstudyauthor Dr. Robert Boyle, a pediatric allergy researcher atImperial College London.

Feeding guidelines have moved away from telling parents toavoid introducing some foods that can cause allergies until kidsare 2 or 3 years old, but most recommendations still stop shortof urging parents to give babies eggs and peanuts early in life.

"Infant feeding advice may need to change," Boyle said byemail.

To see how the timing of babies' introduction to certainallergenic foods influences their risk of allergies, Boyle andcolleagues reviewed data from 146 studies published over thepast 70 years.

When 5.4 per cent of the population has egg allergies, earlyintroduction could avoid 24 cases for every 1,000 people, areview of data from five of those studies with 1,915participants found.

For peanuts, when about 2.5 per cent of the population hasallergies, early introduction could avoid 18 cases for every1,000 people, a review of data 1,550 participants found.

Researchers didn't find enough evidence to determine whetherearly introduction of fish might reduce the likelihood ofallergies in general and nasal allergies in particular.

They also looked at whether giving babies gluten, a proteinin wheat, rye and barley, early might increase the risk ofceliac disease, an autoimmune disorder that damages the smallintestine and interferes with the absorption of nutrients fromfood.

But the timing of gluten introduction didn't have any impacton whether kids developed celiac disease.

In addition, researchers found no evidence that the timingof introduction of allergenic foods like eggs, peanuts and fishinfluenced the odds of developing other autoimmune disorderssuch as Type 1 diabetes.

One limitation of the analysis is that individual studieshad different designs and populations, making it hard to draw broad conclusions that could apply to all children, the authorsnote in JAMA.

No panacea

Most infant feeding guidelines consider exclusivebreastfeeding for the first six months to be ideal, but fewwomen meet that goal, and many who do breastfeed their babiesfor six full months still introduce solids starting around age 4months.

Early introduction of potentially allergenic foods may notbe a panacea in preventing allergies, Dr. Matthew Greenhawt, aresearcher at the University of Colorado School of Medicine inAurora writes in an accompanying editorial.

Still, for most children, parents probably don't need toconsult a doctor before introducing these foods, Greenhawt saidby email.

Consult a doctor for at-risk kids

"Most children are not at risk for developing food allergyand thus, they wouldn't need any specific intervention orsupervision," Greenhawt said.

The picture is different for kids who have a high risk ofdeveloping food allergies, which can include children withsevere eczema, an existing food allergy or a sibling with apeanut allergy.

Parents of at-risk kids should consult a doctor or allergyspecialist before introducing foods that can trigger an allergicreaction, Greenhawt added.

The current research review doesn't address how much egg orpeanut to give kids, or how often, for optimal allergy
prevention, Boyle noted.

And of course, a 4-month-old can choke on whole peanuts, andshould get this food in peanut butter form.

The current study adds to a growing body of evidencesuggesting that early introduction of eggs and peanuts can helpat least some children develop a tolerance to these foods whowould otherwise be allergic, said Dr. Sandra Hong, an allergistat Cleveland Clinic in Ohio who wasn't involved in the study.

"I do think that the findings suggest a need to considerchanges to clinical practice," Hong said by email. "Foodallergies have the potential to result in life-threateningreactions."