This is how you can prevent food allergies in your children
Infants who received small portions of peanuts, milk, wheat and eggs from the age of three months had a lower risk of developing a food allergy when they were three years old compared to a control group.
It can be difficult to know when we should introduce young children to different types of food.
Until quite recently, we were recommended to wait to introduce foods such as peanuts, milk, eggs and wheat because there was a chance that children could become allergic.
But things have started to change.
Norwegian and Swedish researchers have investigated the early introduction of foods with allergens. Their results were recently published in The Lancet.
Findings show that babies who are introduced to peanuts, eggs, milk and wheat at a young age have a lower risk of developing allergies.
Previous research on food allergies
The results of the new study show that children who were exposed to these foods at an early age, on average, had a 1.1 per cent chance of developing a food allergy by the age of three.
Those who did not try these foods had a 2.6 per cent chance of developing a food allergy.
Food allergies can range from mild to acute, life-threatening allergic reactions. This affects around 5 to 8 per cent of all children, according to the Norwegian Asthma and Allergy Association.
Previous studies have suggested that introducing allergenic foods may reduce the risk of food allergies in children who are already at increased risk of developing allergies.
But there has been no evidence that it would also have an effect amongst children in general, the researchers behind the study write in a press release (link in Swedish).
Some also received treatment for atopic eczema
The study included 2,397 children from Norway and Sweden who were selected to participate in one of four treatment groups from the age of three months.
The first group was introduced to peanut butter, milk, wheat, and boiled eggs.
The second group was introduced to the same food in addition to an emollient skin treatment for atopic eczema.
The third group received only the skin treatment.
The fourth group of children did not receive any specific treatment and thus acted as the control group.
The parents of the children in the last two groups were asked to follow the national guidelines for the introduction of food.
Largest effect on peanut allergy
Those who were introduced to peanuts at the age of three months had only a 0.7 per cent chance of developing a peanut allergy before the age of three.
Amongst the children in the control group – those who were not given peanut butter – the chance of developing a peanut allergy was 2 per cent.
“It is a significant protective effect,” researcher Björn Nordlund at Karolinska Institutet in Stockholm says in the press release.
“Early introduction clearly reduced the risk of developing a peanut allergy; an allergy you carry with you all your life, with the risk of serious allergic reactions and a concern that often affects your quality of life.”
Is it risky to recommend young infants be exposed to peanuts?
Peanut allergy can be very serious and extremely dangerous. Your throat swells and you have difficulty breathing – a single peanut can be life-threatening for a child who is allergic.
So is it really safe to encourage parents to feed their babies peanuts?
Throughout the study, the researchers observed no safety issues or severe allergic reactions due to the early introduction of food.
“For safety's sake, we introduced peanuts during a visit to the clinic at the age of three months, but it did not seem necessary. None of the children had an allergic reaction to the first peanut taste test, so it seems as safe as the other foods introduced in the study,” Nordlund says in the press release.
Important to prevent food allergies
Paediatrician Bente Kvenshagen believes that introducing allergenic foods to children from three to four months of age can prevent allergies.
“One of the most important things we can do in this part of medicine is prevention. I tell all my patients that they should start introducing allergenic foods at about four months of age. All my grandchildren who were at an increased risk of developing allergies have also been introduced to food allergens in the same way,” Kvenshagen tells Dagbladet.
Having a family history of allergies means that you are at increased risk of developing allergies yourself.
Kvenshagen believes there is no risk in introducing allergenic foods to infants in the amounts recommended in the study.
And according to her, you will always be able to see a reaction – in the form of a rash on the face and around the mouth – before it eventually becomes more serious.
Start with tiny amounts
The parents of the children in the study were asked to start with very small amounts.
The children were first introduced to peanuts, then cow's milk the following week, followed by wheat porridge and eggs.
The parents were asked to let the child taste these foods at least four days a week as a supplement to breast milk or baby formula.
Only tiny portions were introduced in the beginning. For example, the infants were allowed to suck on a finger dipped in peanut butter or taste a tiny amount on a teaspoon.
After six months of age, parents were encouraged to continue implementing the four foods as part of their diet.
A lot of misinformation
There is a lot of misleading information about allergies in children floating around the internet.
A study from 2017 shows, for example, that only one in ten children with diagnosed food allergies were actually allergic.
And in a study from 2019, only half of those who thought they had a food allergy were really affected (link in Norwegian).
As early as 2015, researchers concluded that eating peanuts prevents peanut allergy. They found that young children who were given peanuts had a whole 80 per cent lower chance of developing allergies than children who were kept completely away from peanuts (link in Norwegian).
The new study now confirms that early introduction of peanuts has a protective effect against peanut allergy.
Translated by Alette Bjordal Gjellesvik.
Read the Norwegian version of this article on forskning.no
Skjerven et al. Early food intervention and skin emollients to prevent food allergy in young children (PreventADALL): a factorial, multicentre, cluster-randomized trial, The Lancet, 2022. https://doi.org/10.1016/S0140-6736(22)00687-0