Introduction of Complementary Foods to Infants - PubMed

Affiliations

• PMID: 28521316
• DOI: 10.1159/000457928

Review

Introduction of Complementary Foods to Infants

Christina West. Ann Nutr Metab. 2017.

Abstract

While earlier food allergy prevention strategies implemented avoidance of allergenic foods in infancy, the current paradigm is shifting from avoidance to controlled exposure. This review focuses on the outcome of recent randomized controlled trials, which have examined the early introduction of allergenic foods for allergy prevention, and discusses the implementation of results in clinical practice. In infants at high risk of allergic disease, there is now direct evidence that regular early peanut consumption will reduce the prevalence of peanut allergy, compared to avoidance. Many international infant feeding guidelines already recommend complementary foods, including allergenic foods, to be introduced from 4 to 6 months of age irrespective of family history risk. Interim guidelines from 10 International Pediatric Allergy Associations state that healthcare providers should recommend the introduction of peanut-containing products into the diets of infants at high risk of allergic disease in countries where peanut allergy is prevalent. Direct translation of the results obtained from a cohort of high-risk infants to the general population has proved difficult, and issues regarding feasibility, safety, and cost-effectiveness have been raised. Five randomized placebo-controlled trials have assessed the effects of early egg exposure in infancy with varying results. In a recent comprehensive meta-analysis, there was moderate-certainty evidence that early versus late introduction of egg was associated with a reduced egg allergy risk. Although promising, optimal timing, doses, and if the feeding regimen should be stratified according to infant allergy risk remain to be determined. The single study that assessed introduction of multiple foods from 3 months whilst breastfeeding compared with exclusive breastfeeding until 6 months of age showed no reduction in food allergy prevalence. Future research should aim at optimizing infant feeding regimens and support a tolerogenic gastrointestinal microenvironment during the period of food allergen introduction.

Keywords: Eczema; Egg; Food allergy; Infant; Peanut; Prevention; Solid foods.

Similar articles

• Solid Food Introduction and the Development of Food Allergies.

  Caffarelli C, Di Mauro D, Mastrorilli C, Bottau P, Cipriani F, Ricci G. Caffarelli C, et al. Nutrients. 2018 Nov 17;10(11):1790. doi: 10.3390/nu10111790. Nutrients. 2018. PMID: 30453619 Free PMC article. Review.

• Early Introduction of Food Allergens and Risk of Developing Food Allergy.

  Yakaboski E, Robinson LB, Arroyo A, Espinola JA, Geller RJ, Sullivan AF, Rudders SA, Camargo CA. Yakaboski E, et al. Nutrients. 2021 Jul 5;13(7):2318. doi: 10.3390/nu13072318. Nutrients. 2021. PMID: 34371828 Free PMC article.

• Timing of Allergenic Food Introduction and Risk of Immunoglobulin E-Mediated Food Allergy: A Systematic Review and Meta-analysis.

  Scarpone R, Kimkool P, Ierodiakonou D, Leonardi-Bee J, Garcia-Larsen V, Perkin MR, Boyle RJ. Scarpone R, et al. JAMA Pediatr. 2023 May 1;177(5):489-497. doi: 10.1001/jamapediatrics.2023.0142. JAMA Pediatr. 2023. PMID: 36972063 Free PMC article.

• Food allergy and the introduction of solid foods to infants: a consensus document. Adverse Reactions to Foods Committee, American College of Allergy, Asthma and Immunology.

  Fiocchi A, Assa'ad A, Bahna S; Adverse Reactions to Foods Committee; American College of Allergy, Asthma and Immunology. Fiocchi A, et al. Ann Allergy Asthma Immunol. 2006 Jul;97(1):10-20; quiz 21, 77. doi: 10.1016/s1081-1206(10)61364-6. Ann Allergy Asthma Immunol. 2006. PMID: 16892776

• Food allergy prevention: current evidence.

  Baker MG, Nowak-Wegrzyn A. Baker MG, et al. Curr Opin Clin Nutr Metab Care. 2020 May;23(3):196-202. doi: 10.1097/MCO.0000000000000651. Curr Opin Clin Nutr Metab Care. 2020. PMID: 32235268 Review.

Cited by

• The influence of household structure and composition on the introduction of solid, semisolid and soft foods among children aged 6-8 months: An analysis based on Ethiopia Demographic and Health Surveys.

  Irenso AA, Zheng M, Campbell KJ, Chamberlain D, Laws R. Irenso AA, et al. Matern Child Nutr. 2023 Jan;19(1):e13429. doi: 10.1111/mcn.13429. Epub 2022 Sep 23. Matern Child Nutr. 2023. PMID: 36148628 Free PMC article.

• The Effect of Digestion and Digestibility on Allergenicity of Food.

  Pali-Schöll I, Untersmayr E, Klems M, Jensen-Jarolim E. Pali-Schöll I, et al. Nutrients. 2018 Aug 21;10(9):1129. doi: 10.3390/nu10091129. Nutrients. 2018. PMID: 30134536 Free PMC article. Review.

• Food Allergy Prevention: Early Versus Late Introduction of Food Allergens in Children.

  Kakieu Djossi S, Khedr A, Neupane B, Proskuriakova E, Jada K, Mostafa JA. Kakieu Djossi S, et al. Cureus. 2022 Jan 9;14(1):e21046. doi: 10.7759/cureus.21046. eCollection 2022 Jan. Cureus. 2022. PMID: 35155013 Free PMC article. Review.

• Complementary Feeding: Recommendations for the Introduction of Allergenic Foods and Gluten in the Preterm Infant.

  Chiale F, Maggiora E, Aceti A, Liotto N, Coscia A, Peila C, Baldassarre ME, Bertino E, Cresi F. Chiale F, et al. Nutrients. 2021 Jul 20;13(7):2477. doi: 10.3390/nu13072477. Nutrients. 2021. PMID: 34371985 Free PMC article.

• Maternal awareness to the timing of allergenic food introduction in Saudi infants: A cross-sectional study.

  Almutairi AM, Aldayel AA, Aldayel AS, Alhussain HA, Alwehaibi SA, Almutairi TA. Almutairi AM, et al. Int J Pediatr Adolesc Med. 2021 Dec;8(4):239-245. doi: 10.1016/j.ijpam.2021.01.003. Epub 2021 Feb 4. Int J Pediatr Adolesc Med. 2021. PMID: 34401449 Free PMC article.

Publication types

MeSH terms

Substances

LinkOut - more resources

• Full Text Sources

  • Ovid Technologies, Inc.
  • S. Karger AG, Basel, Switzerland

• Other Literature Sources

  • scite Smart Citations

• Medical

  • MedlinePlus Health Information