Details of the study: This study was conducted in the UK. Families were eligible to join the study if their baby was 3 months of age, not a twin, and was exclusively breastfed. The babies were allocated by chance into an early introduction group (n=652) or a standard introduction group (n=651). The average age of participants at enrolment was 3.4 months of age.
Early introduction group: Once enrolled in the study, babies in the early introduction group were tested to make sure they were not already allergic to the common allergy causing foods. This was by skin prick testing, followed by an oral food challenge if the baby had a positive skin prick test to a food allergen. Families of babies with positive skin prick testing but who passed the food challenge were advised to include that food in their diet. Families of babies who did not pass a food challenge were advised to avoid that food in their diet.
After the testing, families were advised to introduce six common allergy causing foods to the baby’s diets: cow’s milk (yogurt) first, followed (in random order) by peanut, cooked (boiled) hen’s egg, sesame, and white fish; wheat was introduced last. Families were asked to feed their baby a certain amount of each allergy causing food twice a week. Breastfeeding was supported.
Standard introduction group: Participants in the standard introduction group were to be exclusively breast-fed to approximately 6 months of age. After 6 months of age, parents introduced solid foods, including common food allergens according to their normal feeding practise.
Study Outcomes: The primary outcome of the study was challenge-proven food allergy to one or more of the six early introduction foods between 1-3 years of age.
Key findings: The study found no significant difference in food allergy rates in the primary analysis (intention to treat analysis) between the early and standard introduction groups (5.6%; 32 of 567 vs 7.1%; 42 of 595; p=0.32).
There was no difference in breastfeeding rates at 12 months for individuals in the early introduction group, compared with the exclusive breastfeeding group, showing that earlier introduction of allergenic foods did not have an impact on breastfeeding.
The early introduction of all six foods was not easily achieved because of the young age of the babies and the amount of food allergen they were expected to eat.
References:
Perkin MR, Logan K, Tseng A et al. Randomized trial of introduction of allergenic foods in breast-fed infants. N Engl J Med 2016; 374(18):1733–43.
Perkin MR, Logan K, Marrs T et al. Enquiring About Tolerance (EAT) study: Feasibility of an early allergenic food introduction regimen. J Allergy Clin Immunol 2016; 137(5):1477–86.
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