Until recently, infant feeding guidelines have long recommended delaying introduction of solids and allergenic foods to prevent allergy in high-risk infants, despite a paucity of evidence.In a population-based cross-sectional study of 2,600 infants, parents reported on infant feeding before skin prick testing for egg white. Egg-sensitized infants were then offered an egg oral food challenge (OFC).
Compared with introduction at 4 to 6 months, introducing egg into the diet later was associated with higher risks of egg allergy:
- odds ratio [OR] 1.6 for introduction at 10-12 months
- OR 3.4 for introduction after 12 months
At age 4 to 6 months, first exposure as cooked egg reduced the risk of egg allergy compared with first exposure as egg in baked goods (OR, 0.2).
Duration of breast-feeding and age at introduction of solids were not associated with egg allergy.
Introduction of cooked egg at 4 to 6 months of age might protect against egg allergy.
Oral Food Challenges (click to enlarge the diagram).
References:
Can early introduction of egg prevent egg allergy in infants? A population-based study. J Allergy Clin Immunol. 2010 Oct;126(4):807-13.
No evidence to recommend routine food allergy testing before introducing highly allergenic foods. Restricting maternal diet during pregnancy or lactation is not recommended for preventing food allergy. Medscape, 2011.
Ovomucoid- and ovalbumin-specific IgE/IgG(4) ratios predict reactivity to baked egg. JACI, 2012.
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