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Adherence to Australian Infant Food Allergen Introduction Guidelines: Factors Influencing Infant Feeding Practices
Alexsandria Odoi1, Victoria X Soriano2, Kirsten P Perrett3
1Population Allergy, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, Parkville, Melbourne, Victoria, Australia.
Insights
Accurate infant feeding advice, particularly from maternal child health nurses (MCHNs), significantly increases timely allergen introduction. However, culturally diverse families receive less accurate advice, highlighting a gap in allergy prevention efforts.
Area of Science:
- Pediatric Allergy and Immunology
- Public Health Nutrition
- Evidence-Based Guideline Implementation
Background:
- Updated 2016 Australian infant feeding guidelines promoted earlier allergen introduction.
- Understanding community uptake factors is crucial for effective allergy prevention strategies.
Purpose of the Study:
- To investigate how families receive infant feeding advice.
- To identify factors associated with the accuracy and receipt of this advice.
- To determine the impact of feeding advice on allergen introduction timing.
Main Methods:
- A population-based study (EarlyNuts) surveyed 1699 infants aged 11-15 months.
- Parent-completed questionnaires collected data on demographics, feeding advice, and allergen introduction.
- Statistical analysis examined associations between advice receipt, accuracy, and introduction timing.
Main Results:
- 99% of families received feeding advice, with high accuracy for solids, egg, and peanut.
- Accurate advice was strongly linked to timely introduction of peanut, egg, tree nuts, and dairy.
- Maternal child health nurses (MCHNs) were the primary advice source, associated with increased timely introduction of key allergens.
- Infants of parents born outside Australia and families in specific regions received less accurate advice.
Conclusions:
- Widespread receipt and accuracy of infant feeding advice correlate with timely allergen introduction.
- Culturally and linguistically diverse families face lower rates of accurate advice.
- Local council and MCHN programs appear beneficial for guideline dissemination and adherence.
Background:
There has been a striking shift toward earlier allergen introduction after updated 2016 Australian infant feeding guidelines. Identifying factors contributing to community uptake is important for ongoing allergy prevention efforts.
Objective:
To determine whether and how families received feeding advice, factors associated with the receipt and accuracy of advice, and the influence of advice on allergen introduction.
Methods:
Parent-completed questionnaires from the EarlyNuts population-based study of 11- to 15-month-old infants (n = 1,699), captured demographic characteristics, timing of allergen introduction, and information about feeding advice.
Results:
Most families (99%) received feeding advice. Advice accuracy was highest for solids, egg, and peanut (93% to 97%), and lowest for dairy (81%). Families receiving accurate advice had greater odds of timely (4-11 months) introduction of peanut (odds ratio [OR] = 9.2; 95% CI, 5.5-15.6), egg (OR = 6.2; 95% CI, 2.9-13.4), tree nuts (OR = 3.0; 95% CI, 1.9-5.0), and dairy products (OR = 2.9; 95% CI, 1.8-4.7). Maternal child health nurses were the most common source of advice (87%) and were associated with increased odds of timely peanut (OR = 1.5; 95% CI, 1.0-2.2; P = .04), egg (OR = 2.2; 95% CI, 1.4-3.6; P = .001), and dairy (OR = 1.7; 95% CI, 1.0-2.8; P = .04) introduction. Infants with parents born outside Australia were less likely to receive allergen advice (eg, peanut advice: Australia [92%], other country [80%], and East Asia [76%]). Families residing in the North East region of Melbourne (Australia) had the highest rates of any group and accurate advice.
Conclusions:
The receipt and accuracy of infant feeding advice was widespread and associated with timely allergen introduction; however, rates were lower in culturally and linguistically diverse families. Guideline dissemination and adherence likely benefited from local council and maternal child health nurse programs.
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