The American Academy of Pediatrics today issued a clinical report to guide early feeding for children at risk for allergy. Breast-feeding again comes out on top but contrary to advice offered in 2000, food avoidance during pregnancy is no longer a concern. The clinical report if nothing else serves as an excellent review of what’s known about early feeding and the risk for allergy.
Here are the take home points:
1. The restriction of peanuts or other foods during pregnancy or breast-feeding doesn’t lower a child’s risk of allergies.
2. For infants with a family history of allergy, exclusive breast-feeding for at least 4 months can lessen the risk of cow milk allergy early in life.
3. Among formula fed infants at risk for developing allergies there is evidence that allergy be delayed or prevented by the use of partially hydrolysed formulas (Nutramigen, Alimentum, Good Start).
4. Soy-based infant formula has no role allergy prevention.
5. There is no convincing evidence that delaying the introduction of solids beyond 4-6 months has any effect on preventing allergy.
Beyond the part about giving mom free reign to enjoy a PayDay bar, the recommendation of hydrolysed formula for non breast-feeding babies at risk for allergy is interesting. As a man on the street (or clinic in my case) I would say that this isn’t anywhere near the standard of care and it’ll be interesting to see if the pediatricians pick up on it.