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SmartStartAllergy: a novel tool for monitoring food allergen introduction in infants
Michael O'Sullivan1,2,3, Sandra Vale2,4, Richard Ks Loh1,4
1Perth Children's Hospital, Perth, WA.
Insights
Most Australian infants now consume peanut products by 12 months. The SmartStartAllergy study monitored infant feeding and parent-reported food reactions, finding dairy most frequently caused reactions.
Area of Science:
- Pediatric Allergy
- Infant Nutrition
- Public Health Surveillance
Background:
- Infant feeding practices are evolving.
- Early introduction of allergens is a key area of research.
- Understanding parent-reported reactions is crucial for allergy management.
Purpose of the Study:
- To determine the proportion of infants introduced to peanut and common food allergens by 12 months.
- To gather data on parent-reported food reactions in infants.
- To assess current infant allergy prevention strategies.
Main Methods:
- An observational cohort study using the SmartStartAllergy SMS protocol and online questionnaires.
- Recruited 3374 parents of 12-month-old infants across 69 Australian general practices.
- Collected data on infant allergen exposure and parent-reported reactions.
Main Results:
- 86.2% of infants were introduced to peanut-containing foods by 12 months.
- 12.8% of parents reported food-related reactions.
- Dairy was the most common reported allergen (8.6%), followed by peanut (2.6%).
Conclusions:
- A significant majority of Australian infants are introduced to peanut early.
- The SmartStartAllergy program effectively monitors infant feeding and reactions in primary care.
- Further investigation is needed for non-IgE mediated reactions.
Objectives:
To estimate the proportion of infants introduced to peanut and other common food allergens by 12 months of age; to collect information about parent-reported reactions to food.
Design, Setting:
Observational cohort study, applying the SmartStartAllergy SMS protocol and online questionnaire to parents of 12-month-old infants attending 69 Australian general practices between 21 September 2018 and 3 May 2019.
Participants:
3374 parents recruited via the 69 participating general practices.
Main Outcome Measures:
Proportions of infants who had eaten peanut and other common food allergens; proportions with parent-reported reactions to food.
Results:
1940 of 3374 invited parents participated in the study (response rate, 57%), of whom 836 (46%) completed the online questionnaire. At 12 months of age, 1673 of 1940 infants had eaten peanut-including foods (86.2%; 95% confidence interval [CI], 84.6-87.7%); 235 of 1831 parents (12.8%; 95% CI, 11.3-14.5%) reported food-related reactions. Questionnaire responses indicated that dairy was the food type most frequently reported to cause a food-related reaction (72 of 835 exposed infants, 8.6%; 95% CI, 6.8-11%); peanut-related reactions were reported for 20 of 764 exposed children (2.6%; 95% CI, 1.6-4.0%). 97 of 250 parent-reported reactions to food (39%) did not include symptoms that suggested an IgE-mediated allergic reaction.
Conclusion:
Infant feeding practices in Australia have changed over the past decade; a large majority of infants are now fed peanut before 12 months of age. The SmartStartAllergy program allows monitoring of infant feeding practices in primary care, as well as of parent-reported reactions to food in infants.
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