My daughter took part in a large study that led to similar guidance being introduced in the UK. The was randomised into the early introduction group, which meant that she had to eat peanut, egg, cow's milk, fish, wheat and sesame on a regular schedule when she was a baby. It was interesting - though lots of work, and when she was old enough to understand why she was going up to London for the follow-up tests, she was very proud of her role as "scientist". It was very satisfying when the results were published many years later, proving the hypothesis.
> ... Early introduction of all the foods was not easy but it was safe. Among the infants who did manage to consume the recommended quantity of the allergenic foods there was a two-thirds reduction in overall food allergy.
> For those who fed their infant the recommended amount of peanut there was a significant reduction in peanut allergy, 2.5% in the standard introduction group compared to no cases in the early introduction group (0%).
> There was also a significant reduction for egg allergy- 5.5% in the standard introduction group compared to 1.4% in the early introduction group.
In other words, in the group as a whole when considering all food allergies, the difference was not statistically significant, but that can be attributed to a large number of families in the test group failing to actually perform the test. It sounds like when you control for actually following the instructions there is a statistically significant difference in overall food allergy incidence.
OP took a sentence out of context that said that overall food allergies across the whole group were not reduced by a statistically significant amount. But the authors go on to explain why that was and explain that if you control for real participation in the test then it is significant.
I didn't. There is no context there. It's not the whole group that were not reduced. Read the sentence again:
> food allergy was lower in the group introduced to allergenic foods early but the difference was not statistically significant
Group introduced to allergenic foods early. And of course if you control for kids that don't already display an allergy at the age that they're introducing it, you're going to have a reduced rate of allergy.
There's a reason they're saying it's not statistically significant...
It was statistically insignificant among the whole early introduction group. This includes everyone who may have been randomised into that group but then didn't follow the (quite onerous) regimen that we were given. This was a full schedule of when different foods had to be fed to the baby and how much. We'd have to record whether they had eaten the amount required and so on. Among those who did follow it, the results were significant. Most importantly, there were zero cases of peanut allergy in that group.
and IIRC you need to maintain consistent exposure to the allergens throughout the first, idk, 18 months of life to have the best result. So don't just expose them once early on and stop.
Yes that's part of the advice in the Netherlands as well. Keep giving them things that can be common allergies.
My 4 year old's favourite food is shrimp and sushi... Not sure whether it's related to her eating those when she was a toddler, but it's fun to see the reactions in restaurants when you don't order the children's menu.
There's very strong evidence of the success of this -- for babies with no indication of a peanut allergy, intentional exposure led to an ~85% reduction in allergies -- for those who had a positive allergy test before the study, they had a ~70% reduction in allergies by 5 years old.
> Among the 530 infants in the intention-to-treat population who initially had negative results on the skin-prick test, the prevalence of peanut allergy at 60 months of age was 13.7% in the avoidance group and 1.9% in the consumption group (P<0.001). Among the 98 participants in the intention-to-treat population who initially had positive test results, the prevalence of peanut allergy was 35.3% in the avoidance group and 10.6% in the consumption group (P=0.004). There was no significant between-group difference in the incidence of serious adverse events. Increases in levels of peanut-specific IgG4 antibody occurred predominantly in the consumption group; a greater percentage of participants in the avoidance group had elevated titers of peanut-specific IgE antibody. A larger wheal on the skin-prick test and a lower ratio of peanut-specific IgG4:IgE were associated with peanut allergy.
It's the opposite. Usually babies don't eat any food at 4 months. They only get breastmilk or formula. The advice is to start early with peanutbutter and egg.
In our case diary products were an issue instead of nuts. My daughter would get very sick from anything that had diary in it, even if my wife ate diary products while breastfeeding. But at about 1.5 years one she got over that and now at 4 she is completely fine drinking normal cow milk.
So allergies in kids are not a permanent set in stone thing. They can get over some, and early exposure makes a difference.
No, it's the opposite. The advice we were given was that it was very important that their first encounter with the allergens was to eat them, and not to allow skin contact or anything before that. This meant that with my youngest we had no peanuts in the house until she was old enough to eat solid food, and peanut butter was the first food she ate. It's still her favourite food!
If you're avoiding skin contact, then you might not have time to wipe the peanut butter mess off your hands as you rush to rescue your kid who's got into trouble.
It wasn't about them not being in the house - it was about not eating them, and particularly not feeding them to her 2 year old sister. We didn't throw them away - we just didn't buy any as we weren't going to be eating it for a while.
Babies change fast. I can certainly imagine it. You won't know when exactly the flip happens, so you err on the safe side. Also, spread of stuff though the air and by hands: I thought we just spend lockdowns realising that crap spreads far and wide.
I am not sure if you had a child or not, but you don't give the baby food before 4 to 6 months. So its not that you aren't exposing them at all, but not feeding them the food.
There are powders to add to your formula / breast milk to introduce allergens early (we used Ready Set Food but easy to DIY). Kind of annoying since they often clog the nipple of the bottle, but we did it with my daughter who is now 20 months and her favorite breakfast is a spoon of peanut butter. Sesame gives her a slight reaction still, we unfortunately don’t eat it very often.
I'm assuming you're not a parent, but it's a valid question! No food before 4 months, babies can and should subsist on breastmilk or formula before that.
Where does the peanut and egg allergy come from? My understanding is that peanut oil and egg albumin are ingredients in many common medicines given early to infants.. is there any chance that could be contributing?
Egg albumin is also interesting because the vast majority of kids outgrow it. My toddler has a peanut allergy but has already outgrown his egg albumin allergy.
It does make you wonder if we shouldn’t vaccinate until exposing the children to solid foods in ordinary healthy cases. The mother’s antibodies from her milk do good work.
There are other commenters warning about skin exposure before dietary exposure. If that’s true then it would make sense.
If you say certain words you get downvoted but I’ve found people seem to keep an open mind more if you use words like “medicine” that don’t immediately challenge deeply held beliefs
Interesting point about the skin exposure, I’ll go back and review those comments. Evolutionarily/practically i would think it’s tough to get oral exposure to something prior to skin exposure (it hits your mouth/hands/face before your stomach), unless the breastmilk vector you mention is critical
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