The rising rates of food allergies in Australia and other countries prompted a review of infant feeding guidelines, to review the evidence behind the increasing rates of allergies and anaphylaxis. Australia saw a five fold increase in hospitalisation with anaphylaxis between 1995 and 2005, which sadly also saw an increase in the number of fatalities from anaphylaxis. The Australasian Society for Clinical Immunology and Allergy (ASCIA) released new guidelines for the introduction of allergenic foods to infants in 2016, focusing on introducing potentially allergenic foods before the age of 12 months. This is in contrast to the previous recommendations of avoiding these types of foods until the age of 1-3 years.
The new infant feeding guidelines have had very positive results, with many parents and healthcare professionals embracing the change. Recent studies into the prevalence of allergies in infants has explored the rates of peanut allergies in Victorian infants, called the ‘The EarlyNuts Study’. Researchers found that despite concerns parents would not introduce potentially allergenic foods to infants, 89% of infants had consumed peanuts before reaching 12 months. This has seen a 16% decrease in the rates of peanut allergies, which supports the latest guideline updates. Further research in the ongoing ‘Vitality Trial’ is exploring if the use of vitamin D supplements can further reduce the risk of peanut allergies, as infants with peanut allergies have been found to be vitamin D deficient in a number of studies.
Summary of Infant Feeding Guidelines:
- Breastfeeding is recommended for the first 6 months of life, and as long as the mother and child wish to continue.
- Formula feeding with standard cow’s milk formula if breastfeeding is not possible.
- No particular food groups should be excluded from the maternal diet during pregnancy and breastfeeding. Current guidelines on safe foods during pregnancy remain unchanged.
- Introducing solids between the ages of 4-6 months whilst continuing to breastfeed/formula feed, once the infant is ready. This will depend on the interest and development of each individual infant.
- All potentially allergenic foods should be given to the infant, unless they are already allergic to that particular food. This includes peanuts and tree nuts (as smooth pastes), cow’s milk, eggs, wheat, soy, sesame, fish and shellfish.
- Introduction of one food at a time, so that any allergies can be quickly identified. If there are no allergies the food should remain as a regular part of the infant’s diet.
- Do NOT smear foods onto the skin, especially for infants with eczema. This is more likely to result in food allergies.
- Smoking is to be avoided, especially during pregnancy or in enclosed spaces with infants.
If you are interested in updating your knowledge on allergies and anaphylaxis, you may be interested in joining us in one of our following courses depending on your area of clinical practice.
For a full list of events and courses please visit https://medcast.com.au/critical-care.
Australian Parliamentary House, 2019. Inquiry into Allergies and Anaphylaxis. Standing Committee on Health, Aged Care and Sport, August.
Australiasian Society for Clinical Immunology and Allergy (ASCIA), 2020. Infant Feeding and Allergy Prevention Clinical Update. ASCIA Position Papers/Guidelines, December.
Murdoch Children’s Research Institute (MCRI), 2021. Decrease in peanut allergy among infants after guideline changes. Institute News, February 25.