Early introduction of allergenic foods and the prevention of food allergy in infancy

Food allergies are common, affecting approximately 6% of children in high-income countries. Infant feeding guidelines previously recommended delaying the introduction of allergenic food, however the Enquiring About Tolerance (EAT) study suggests that early introduction might prevent thousands of children from developing food allergies every year. 

A team of researchers co-led by Dr Michael Perkin, Reader in Clinical Epidemiology, of St George’s, University of London conducted the largest completed and published trial of early allergenic food introduction at the time of publication. The trial was conducted between 2008 and 2015. 

Observational studies showed that Israeli infants, who had peanut introduced into their diet early, had a much lower risk of developing a peanut allergy than North London Jewish infants, suggesting that early allergic food introduction might protect against food allergy. 

The researchers conducted a unique trial in over 1,300 exclusively breastfed infants to determine whether early introduction of six common allergens (peanut, cooked hen’s egg, cow’s milk, sesame, white fish and wheat) from three months of age would prevent the development of food allergies. 

Achieving consumption of allergenic foods at the levels recommended was not easy, but was associated with a significant reduction in food allergy. The Food Standards Agency funded study also found that early introduction was associated with fewer serious sleep problems. The early introduction of wheat was also associated with less coeliac disease developing. 

For specific food allergies the risk reductions were particularly marked if sufficient consumption of the specific food was achieved. Peanut allergy was reduced by 100%, and egg allergies were reduced by 75% when introduced from three months of age and consumed in sufficient quantity. 

The study also identified that Black, Asian and Minority Ethnic groups, who are at increased risk of food allergy, were significantly less likely to adhere to early allergenic food introduction and will require additional support to achieve early introduction. 

Dr Perkin said,

“the EAT study has produced a wealth of data that continues to inform infant feeding guidelines and insights into how allergies develop and their potential prevention”.