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ASCIA Guideline: Infant Feeding for Food Allergy Prevention
S L Vale1,2, M J Netting1,3, C J Hornung4,5,6,7
1National Allergy Council, Sydney, New South Wales, Australia.
Summary
Introduce infants to solids around 6 months, including well-cooked egg and peanut soon after. Offer common allergens weekly to prevent food allergies, with no need for maternal dietary changes or hydrolyzed formulas.
Area of Science:
- Allergy and Immunology
- Pediatric Nutrition
- Public Health Guidelines
Background:
- The Australasian Society of Clinical Immunology and Allergy (ASCIA) updated its 2016 infant feeding guideline for food allergy prevention.
- The guideline provides specific recommendations for infant feeding practices aimed at preventing food allergies.
Purpose of the Study:
- To provide updated recommendations for infant feeding to prevent food allergies.
- To incorporate new evidence and expert consensus into clinical practice guidelines.
Main Methods:
- Systematic evidence review using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) framework.
- Delphi process for recommendations where evidence was lacking, based on expert consensus.
- Formation of an Expert Writing Group with representation from key allergy organizations and research centers.
Main Results:
- 16 recommendations were developed: 8 based on published evidence, 8 on expert consensus.
- Infants should start solids around 6 months (not before 4 months) when developmentally ready.
- Introduce well-cooked egg and peanut soon after solids begin; offer other allergens weekly. Breastfeeding is encouraged; hydrolyzed formulas are not recommended for prevention.
- Mild perioral rashes may not indicate allergy and the food can be offered again.
Conclusions:
- Key updates include specific timing for peanut and egg introduction and guidance on perioral rashes.
- These guidelines aim to support primary healthcare providers in advising families on infant feeding for allergy prevention.
- The guidelines necessitate ongoing review and updates as new scientific evidence emerges.
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