Does early introduction of solids prevent food allergy?

Parents of young infants often ask me when should I introduce solid foods. There is evidence that early introduction of solids may reduce the risk of development of immediate food allergies. Delayed introduction of foods does not protect against food allergy, and may even promote food allergies. Guidelines use to suggest delay nut introduction until the child was 5 years of age – this certainly did not reduce the rate of nut allergies. Currently it is recommended solids can be introduced around 6 months, but not before 4 months. The key recommendations are:

 

  • When your infant is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods, starting with iron rich foods, while continuing breastfeeding.
  • All infants should be given a wide range of solid foods including peanut butter, cooked egg, dairy and wheat products in the first year of life. This includes infants at high risk of allergy. It is important once you start such foods, to continue them on a regular basis in your infant’s diet.
  • There is strong evidence that introduction of peanut before 12 months reduces the risk of peanut allergy, particularly in those with severe eczema or egg allergy.
  • There is moderate evidence that introduction of egg before 12 months also reduces the risk of egg allergy, although the risk of immediate egg allergy appears to be greater in those with severe eczema.

However, it is not possible to prevent food allergies by early introduction alone. Some children will still react even if foods are introduced under 12 months, suggesting that other, other factors, must also play a role. Traditionally, our grandparents introduced a variety of foods early and allergy rates were lower. So maybe grandparents know best after all!