Navigating early allergenic food introduction: Practices and barriers among parents and caregivers

Early introduction of allergenic foods to infants starting 4-6-months of age has been shown to effectively prevent the development of food allergies. This project examines the practices and barriers among parents and caregivers toward feeding infants allergenic foods.

A cross-sectional online survey was conducted from January to March 2024 with primary focus on the Midwest area of the United States. The survey was advertised through local health departments and social media platforms. Parental practices on feeding allergenic foods to their infants, as well as perceived barriers were collected. Descriptive and inferential statistical analyses were used to summarize participant demographics, parental willingness and feelings toward allergenic food introduction, and the actual practices. Thematic analysis was employed to identify qualitative data such as parental concerns and barriers.

The study included 563 valid responses from parents and caregivers of children aged 5 years or younger. The surveyed infants were predominantly white (84.9%) and female (58.1%), with a mean age of 7.5 months. Among families who had introduced solid foods to their infants (n = 529), eggs (72%) and wheat (63%) had the highest introduction rates by age one, while shellfish (44%) and sesame (52%) had the lowest. Only 55.9% of families reported receiving guidance from healthcare providers on allergenic food introduction. Thematic analysis revealed concerns about inconsistent advice, fear of allergic reactions, cultural beliefs, social media influence, and safety concerns such as choking hazards and inconsistent allergen labeling.

Parents and caregivers exhibited caution in feeding allergenic foods to their infants by age one. Barriers included lack of awareness, cultural practices, conflicting guidance, and social media influences.