Although significant evidence exists that feeding early has a role in the prevention of food allergy, this intervention in isolation may not be sufficient. Recent evidence highlights that early introduction of peanut specifically has had no significant impact on the populational prevalence of peanut allergy. Other factors that may contribute to food allergy prevention include regularity of ingestion once an allergen is introduced and consideration to the form in which the allergen is introduced (such as baked versus cooked egg). There are also many practicalities to early feeding and some discrepant viewpoints on these practicalities, which has led to poor implementation of early feeding strategies. In general, preemptive screening before food introduction is not recommended by most international allergy societies. Although there is little guidance to inform early introduction of allergens other than milk, egg, and peanut, the mechanism of sensitization is thought to be similar and there is no harm to early introduction. In terms of frequency and duration of feeding, there is little evidence to inform any concrete recommendations.
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November 2023
State-of-the-Art Review|
October 11 2023
Updates in Food Allergy Prevention in Children
Elissa M. Abrams, MD, MPH;
aSection of Allergy and Clinical Immunology, Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
bDivision of Allergy & Immunology, Department of Pediatrics, University of British Columbia, British Columbia Children’s Hospital, Vancouver, British Columbia, Canada
Address correspondence to Elissa M. Abrams, MD, MPH, Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, FE125-685 William Avenue, Winnipeg, MB, Canada R2A 5L9. E-mail: [email protected]
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Marcus Shaker, MD, MSc;
Marcus Shaker, MD, MSc
cSection of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, and Dartmouth Geisel School of Medicine, Hanover, New Hampshire
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David Stukus, MD;
David Stukus, MD
dDivision of Allergy and Immunology, Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, Ohio
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Douglas P. Mack, MD, MSc;
Douglas P. Mack, MD, MSc
eDepartment of Pediatrics, McMaster University, Hamilton, Ontario, Canada, and Halton Pediatric Allergy, Burlington, Ontario, Canada
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Matthew Greenhawt, MD, MBA, MSc
Matthew Greenhawt, MD, MBA, MSc
fSection of Allergy and Clinical Immunology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
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Address correspondence to Elissa M. Abrams, MD, MPH, Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, FE125-685 William Avenue, Winnipeg, MB, Canada R2A 5L9. E-mail: [email protected]
Pediatrics (2023) 152 (5): e2023062836.
Article history
Accepted:
June 28 2023
Citation
Elissa M. Abrams, Marcus Shaker, David Stukus, Douglas P. Mack, Matthew Greenhawt; Updates in Food Allergy Prevention in Children. Pediatrics November 2023; 152 (5): e2023062836. 10.1542/peds.2023-062836
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