Infant Diet Recommendations Reduce IgE-Mediated Egg, Peanut, and Cow’s Milk Allergies
This study aimed to compare the prevalence of IgE-mediated food allergies at 1 year of age between two groups (cohorts) of babies born in Western Australia, before and after the updated Australasian Society of Clinical Immunology and Allergy infant feeding and allergy prevention guidelines were released in 2016.
Details of the study: This study was conducted in Western Australia. It compared information on infant feeding, the prevalence of food allergen sensitisation and IgE mediated food allergy in two different groups (cohorts) of infants.
Group 1: 506 infants born 2006-2014. No infant feeding advice was provided to participants.
Group 2: 566 infants born 2016-2022. When the infants were 6 months of age, all families were provided with updated infant feeding and allergy prevention guidelines.
All infants had a first-degree relative (parent or sibling) with a history of allergic disease. At 1 year of age, infant food allergen sensitization and IgE-mediated food allergy were assessed
Key findings:
Age of introduction to common allergy causing foods:
Peanut and egg were introduced earlier in cohort 2 than in cohort 1. On average, babies in cohort 2 were introduced to egg at 6 months, and peanut around 6. ½ months of age, compared with 10 months in cohort 1. At 1 year of age 23% of the infants in cohort 1 had not yet been introduced to egg and 73% had not yet been introduced to peanut, compared to 0.7% of cohort 2 for egg, and 5.8% for peanut. Infants in cohort 2 were introduced to cow’s milk protein earlier than cohort 1 – this is similar to other studies that have reported early introduction to infant formula as complementary feeds in the first week of life.
Prevalence of IgE mediated food allergy at 1 year of age:
At 1 year of age infants in cohort 2 had less IgE mediated food allergy to peanut, egg and cow’s milk when compared to cohort 1. The combined prevalence of IgE-mediated peanut, egg, and/or cow’s milk allergies was 4.1% in cohort 2 compared with 12.6% in cohort 1(adjusted odds ratio [aOR]: 0.28, 95% confidence interval [CI]: 0.16-0.48, P <0.001).
The prevalence of peanut allergy was 1.1% in cohort 2 versus 5.8% in cohort 1 (aOR: 0.24, 95% CI: 0.08-0.76, P [.015), egg allergy 2.8% versus 11.7% (aOR: 0.23, 95% CI: 0.12-0.45, P < 0.001), and cow’s milk allergy 0.5% versus 2.4%, respectively (aOR: 0.14, 95% CI: 0.04-0.55, P [0.005).
This study is the first to demonstrate the reduced prevalence of multiple food allergies after implementation of updated infant feeding and allergy prevention guidelines recommending earlier introduction of peanut, egg, and cow’s milk in infant diets.
References:
Walker SVM, D’Vaz N, Pretorius RA, Lo J, Christophersen C, Prescott SL, et al. Infant Diet Recommendations Reduce IgE-Mediated Egg, Peanut, and Cow’s Milk Allergies. J Allergy Clin Immunol Pract. 2025. 13:3077-83
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