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ASCIA Guide for introduction of peanut to infants with severe eczema and/or food allergy

ASCIA Guide for introduction of peanut to infantsThis guide provides options and information for health professionals about introducing peanut to infants with severe eczema and/or existing food allergy. These infants are considered to have an increased risk of developing peanut allergy.

pdfASCIA HP Guide for introduction of peanut to infants with severe eczema and/or food allergy240.50 KB

Why should this guide be followed?

Recently published studies (1,2) have shown that the introduction of peanut to infants with severe eczema and/or egg allergy before 12 months can reduce the risk of these infants developing peanut allergy by around 80%.

For all infants, including those with severe eczema and/or existing food allergy, peanut and other solid foods should be introduced around 6 months (not before 4 months) and in the first 12 months, when developmentally ready, as recommended in the ASCIA guidelines for infant feeding and allergy prevention.

If possible, it is preferable for mothers to continue breastfeeding whilst introducing solid foods to infants, as there is some (weak) evidence that this may reduce the risk of allergies developing. There are many other health benefits of continued breastfeeding.

ASCIA guidelines for infant feeding and allergy prevention are available open access on the ASCIA website: www.allergy.org.au/hp/papers/infant-feeding-and-allergy-prevention

Suggested procedure for introduction of peanut before 12 months (not before 4 months)
when the infant is developmentally ready for solid food - under medical supervision (e.g. in GP rooms) or at home

Further Information

References

  1. Du Toit G et al. Effect of avoidance on peanut allergy after early peanut consumption. N Engl J Med. 2016. DOI: 10.1056/NEJMoa1514209
  2. Du Toit G et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015 Feb 26;372(9):803-13
  3. Perkin MR et al. Randomised trial of introduction of allergenic foods in breast-fed infants. N Engl J Med. 2016. DOI: 10.1056/NEJMoa1514210
  4. Togias A et al Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases (NIAID) sponsored expert panel. WAO J 2017 10(1):1
    www.ncbi.nlm.nih.gov/pmc/articles/PMC5217343/ 
  5. Turner PJ, Campbell DE. Implementing primary prevention for peanut allergy at a population level. JAMA 2017 Feb 13. www.jamanetwork.com/journals/jama/fullarticle/2603418 

© ASCIA 2017

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Disclaimer

This document has been reviewed by ASCIA members and represents available published literature at the time of review. The content is not intended to replace professional medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner. Development of this document is not funded by any commercial sources and is not influenced by commercial organisations.

Content updated 2017