Allergy Risk Tied to Early Solid Foods
Exclusive Breastfeeding for Six Months Is Protective, Top Allergy Group Says
July 28, 2006 -- New moms should breastfeed exclusively for six months to
help protect their babies against developing food allergies later on,
one of the nation's leading allergy and asthmagroups says.
Solid foods of all types should be avoided for the first six months, and
certain items -- like cow's milk, eggs, fish, and nuts -- should not be
introduced until even later, according to a consensus statement on infant
feeding released this week by the American College of Allergy, Asthma and
"It is important to understand that we are talking about exclusive breastfeeding, with no formula,
soy or anything else," researcher Amal Assa'ad, MD, tells WebMD. "This
appears to be important for protecting against allergies."
The ACAAI committee came up with its recommendations after reviewing the
available clinical evidence. The consensus statement is published in July's
Annals of Allergy, Asthma & Immunology -- the journal of the
Foods Should Be Introduced Gradually
The American Academy of Pediatrics (AAP) also recommends exclusive
breastfeeding for six months, followed by gradual introduction of solid
Some infants and mothers with certain medical conditions or who are
undergoing certain medical treatments should not breastfeed.
AAP guidelines also include detailed suggestions about when infants at risk
for developing allergies should first be given certain foods, which the ACAAI
The ACAAI food allergy committee also specifically recommends that -- when
there is evidence of an increased risk for food allergies -- cow's milk and
other dairy products should be avoided for the first year of life; eggs should
not be given until at least age 2; and peanuts, tree nuts, fish, and other
seafood should be avoided until at least age 3.
Although the foods above are the most likely to trigger allergies, other
foods may also pose a risk if introduced too early, the group noted.
In addition to exclusive breastfeeding and avoidance of
solid foods for six months, the ACAAI committee recommended that:
Staple foods, such as fruits, vegetables, meats, soy, and cereal be
introduced "individually and gradually" to lessen allergy risk.
Mixed foods containing a variety of potentially allergenic foods should be
avoided until the baby's tolerance to each ingredient is known.
Beef, vegetables, and fruits should initially be given in the form of
prepared baby foods that are cooked and homogenized. Studies suggest these
processed foods are less likely to cause allergiesthan their fresh counterparts.
The committee made no specific recommendations regarding introduction of
wheat and cereals into the diets of babies older than six months. "In many
people's minds, wheat is a highly allergenic food, but the clinical evidence
does not support this," Assa'ad says.
"The timing after age 6 months at which specific foods should be
introduced depends on a number of factors, including the individual infant's
nutritional needs and risk for allergies," committee chairman Alessandro
Fiocchi, MD, said.
Evidence Compelling but Not Conclusive
Assa'ad says breast milk contains many of the same food allergens as
individual foods, but instead of promoting allergies, it appears to help babies
become tolerant as their immune systems develop.
Assa'ad acknowledged there is still debate about the impact of food
introduction timing on allergy risk.
Even so, the committee wrote in its consensus state, "There seems to be
no reason why delayed exposure to solid foods should not prove similarly useful
(as the delay of cow's milk) in the prevention of food allergies," the
committee wrote in its consensus statement.