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The British Society for Allergy & Clinical Immunology ‘s Paediatric Allergy Group (PAG) and the Food Allergy Specialist Group (FASG) of the British Dietetic Association (BDA) have developed guidance for UK Healthcare Professionals on preventing food allergy in higher risk infants. This includes advice on the earlier introduction of potential allergenic foods into the infant diet to reduce the risk of food allergy.

This is guidance, not a guideline and is designed to provide practical advice on implementing the evidence available from the EAT, LEAP and other studies. The guidance complements the recent review and joint statement from the Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity of Chemicals in food, Consumer products and the Environment (cot) – “Assessing the health benefits and risks of the introduction of peanut and hen’s egg into the infant diet before six months of age in the UK, which acknowledge that targeted advice may be appropriate for infants at higher risk of developing food allergy.

The Early Feeding Guidance for Healthcare Professional can be accessed here.

A summary of the guidance can be accessed here.

Scientific Advisory Committee on Nutrition (SACN) has published its report on ‘Feeding in the first year of life’, providing recommendations on infant feeding from birth up to 12 months of age.

The last review of infant feeding was undertaken by SACN’s predecessor Committee on Medical Aspects of Food Policy (COMA) in 1994 and formed the basis for government recommendations in the UK.

SACN recommends babies are exclusively breastfed until around 6 months of age and continue to be breastfed for at least the first year of life. Additionally, solid foods should not be introduced until around 6 months to benefit the child’s overall health. This represents no change to current government recommendations.

SACN has recommended strengthening advice regarding the introduction of peanuts and hen’s egg – advice on complementary feeding should state these foods can be introduced from around 6 months of age and need not be differentiated from other solid foods. The deliberate exclusion of peanuts or hen’s egg beyond 6 to 12 months of age may increase the risk of allergy to these foods.

The findings of the systematic review on the timing of introduction of a number of the major food allergens (milk, hen’s egg, fish, shellfish, tree nuts, wheat, peanuts and soya) and later risk of allergic and autoimmune disease (Ierodiakonou et al, 2016) which helped inform the decision;.

There was moderate quality evidence that early introduction of peanut (between 4 to 11 months) was associated with reduced risk of developing peanut allergy.
There was moderate quality evidence that early introduction of hen’s egg (between 4 to 6 months) was associated with reduced risk of developing hen’s egg allergy.
There was low quality evidence that early introduction of fish (before 6 to 12 months of age) was associated with reduced allergic rhinitis and very low quality evidence that fish introduction before 6 to 9 months was associated with reduced allergic sensitisation
There was no association between the timing of introduction of other allergenic foods and risk of food allergy or allergic sensitization

You can read the full report here.

BSACI – Early Feeding Guidance

SACN: Publication of report Feeding in the First Year of Life