Thread by @AllergyKidsDoc

As #FoodAllergyAwarenessWeek winds down, it is important to discuss exciting recommendations about PREVENTION of #foodallergy. Wouldn't it be great if we could curb the rise? This thread will address interventions that may impact this (if adopted on a wide scale) ⬇️

Introducing allergenic foods such as peanut, egg, wheat, milk into a baby's diet early - beginning around 4-6 months AND keeping in the diet is:
-SAFE
-Beneficial
-In line with current recommendations from Allergy orgs and @AmerAcadPeds pediatrics.aappublications.org/content/143/4/…

Current U.S. guidelines recommend early introduction of safe forms of peanut to all infants beginning at 4-6 months (once they are tolerating solids).

Testing for peanut allergy should ONLY be considered for infants at high risk for allergy. Great info: niaid.nih.gov/sites/default/…

This handout provides excellent advice regarding safe forms of peanut to use for feeding infants - thanks @VenterCarina for your expertise! niaid.nih.gov/sites/default/…

NEVER use whole or partial peanuts, which are choking hazards.

There is no evidence to suggest that infants eat one new food every 3, 4, 5, 7 days. The majority of infants will never develop #foodallergy and they should have fun trying new foods.

As they expand their diet, normal changes occur with:
-Poop
-Sleep
-Behavior
-Skin

Mothers can and should eat whatever they want during pregnancy & breast feeding. Their diet does NOT cause #foodallergy to develop. They also cannot prevent food allergies by avoiding or eating certain foods.

It is not mom's fault. Anyone who says differently - send them my way

If possible, breast feeding is recommended for at least 6 months...longer is better. It can be done w early introduction of allergenic foods.

Benefits include helping delay/prevent allergies, bonding, immune support.

For those who can't, it's ok. Guilt free zone here.

Hydrolyzed formulas do NOT prevent #foodallergy or other allergic diseases, even in high risk infants with strong family history, etc. This is a change from prior recommendations but sound evidence has accumulated to support not using for this purpose. pediatrics.aappublications.org/content/143/4/…

The following have not been shown to prevent #foodallergy from developing in infants:
-Probiotics
-Prebiotics
-Vitamin D supplements

Exposure to antibiotics and antacids in the 1st 12 months are ASSOCIATED w increased risk for allergies - causal role TBD. Thoughtful use is key.

Recommendations for early introduction of allergenic foods have changed dramatically. We used to say avoid. Science & understanding change over time.
Accumulating and good EVIDENCE shows us this is our best current path towards preventing #foodallergy. #FoodAllergyAwarenessWeek

NO interventions are 100% effective. Even in the pivotal LEAP trial - a few infants who ingested peanut early developed allergy. But overall difference from those who avoided was tremendous.

To see a real impact on rates of #foodallergy, we need widespread adoption.

I hope this thread helps highlight the current thoughts, recommendations, and evidence surrounding ways in which we may be able to prevent #foodallergy development...and hopefully reverse the trend in increased prevalence.
#FoodAllergyAwarenessWeek