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Early introduction of very small amounts of multiple foods to infants: A randomized trial
Tatsuo Nishimura1, Mitsuru Fukazawa2, Keisuke Fukuoka3
1Nishimura Pediatric Clinic, Osaka, Japan.
Insights
Early infant introduction of multiple allergenic foods (MP) significantly reduced food allergy incidence by 18 months compared to placebo. This approach safely prevents allergies, particularly egg allergies, in high-risk infants.
Area of Science:
- Pediatrics
- Allergology
- Immunology
Background:
- Investigating early dietary interventions for preventing multiple food allergies.
- Assessing the safety and efficacy of simultaneous administration of multiple allergenic foods in infancy.
Purpose of the Study:
- To determine if early, simultaneous exposure to multiple allergenic foods can prevent food allergies in infants.
- Evaluating the risk ratio and incidence of food allergy episodes following a mixed food powder intervention.
Main Methods:
- Randomized, placebo-controlled trial involving 163 infants aged 3-4 months with atopic dermatitis.
- Infants received either mixed allergenic food powder (MP) or placebo powder (PP) with stepwise dose increases until 12 weeks.
- Food allergy episodes were assessed at 18 months of age.
Main Results:
- The incidence of food allergy episodes was significantly lower in the MP group (7/83) compared to the PP group (19/80) (P=0.0066).
- A significant reduction in egg allergies was observed in the MP group.
- Overall food allergy episodes from other tested foods were reduced, though not significantly for individual foods.
Conclusions:
- Gradual introduction of small amounts of multiple allergenic foods in early infancy safely reduces the incidence of egg allergies.
- Early multi-food introduction may offer a protective effect against other food allergies, warranting further investigation.
Background:
We investigated whether multiple food allergies could be safely prevented by simultaneously administering very small amounts of multiple foods.
Methods:
Infants 3-4 months old with atopic dermatitis from 14 primary care pediatric clinics in Japan were enrolled in this randomized, placebo-controlled trial. The infants were administered either mixed allergenic food powder (MP) containing egg, milk, wheat, soybean, buckwheat, and peanuts, or placebo powder (PP). The amount of powder was increased in a stepwise manner on weeks 2 and 4, and continued until week 12. The occurrence of food allergy episodes after powder intervention was assessed at 18 months old. This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (number UMIN000027837).
Results:
A total of 163 participants were randomly allocated to either the MP group (n = 83) or the PP group (n = 80). The incidence of food allergy episodes by 18 months was significantly different between the MP and PP groups (7/83 vs. 19/80, respectively; risk ratio 0.301 [95% CI 0.116-0.784]; P = 0.0066). Egg allergies were reduced in the MP group. In addition, food allergy episodes from any of the other five foods were significantly reduced, although the reductions in those due to individual foods were not significant.
Conclusions:
Gradually increasing the intake of very small amounts of multiple foods in early infancy can safely reduce the incidence of egg allergies. Other foods may also suppress food allergies, but no definitive conclusions could be reached.
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