Allergy 4 All

Primary prevention of allergic disease through nutritional interventions.

Primary prevention of allergic disease through nutritional interventions.

J Allergy Clin Immunol In Pract 2013 Jan; 1:29

Fleischer DM et al.



The American Academy of Allergy, Asthma & Immunology has issued some useful guidance on the introduction of potentially allergenic foods into the diet of high risk children (those who have at least a 1stdegree relative with allergic disease) 


  • Avoidance of allergenic foods during lactation is not recommended.
  • Avoidance of allergenic foods (except peanuts) during pregnancy is not recommended. Data are inconclusive on peanut ingestion during pregnancy and development of peanut allergy. This choice is left for parents to decide.
  • Exclusive breast-feeding is recommended for the first 4 months of life, and breast-feeding ideally should continue through the first year. When breast-feeding is not possible in high-risk children, consider a partial whey hydrolysate formula or extensively hydrolyzed formula. Soy formula has no advantage over milk-based formula for prevention of allergy.
  • Complementary foods can be introduced between ages 4 and 6 months.
  • Highly allergenic foods can be started in small doses at home once other foods such as grains and vegetables are tolerated. New foods can be tried every few days. Early introduction may actually reduce food allergy.
  • Acidic foods such as berries, tomato, and citrus can cause local irritant reactions but rarely cause systemic reactions and do not need to be delayed.
  • Routine allergy testing is not recommended prior to initiation of foods. Allergy consultation might be warranted in infants with severe eczema or history of adverse food reactions.
  • A child with a sibling with peanut allergy has a 7% risk for peanut allergy. Allergy consultation can be considered for such children, although typically the slow introduction of peanut at home is safe. An initial fatal peanut reaction in an infant has never been reported.



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