Early introduction is not enough: CSACI statement on the importance of ongoing regular ingestion as a means of food allergy prevention

Abstract

[...]guidelines clearly and consistently recommend early allergen ingestion (commonly operationalised as between ages 4–6 months), often in particular for higher risk populations, as a means of food allergy prevention [3, 5]. [...]the goal of this statement is to emphasize that current best evidence supports the importance of regularity of infant allergen ingestion, operationalised as at least once weekly, as a means of food allergy prevention. [...]our recommendations and considerations on frequency of ingestion are as follows (Fig. 1): [IMAGE OMITTED: Considerations: * Once introduced, current evidence suggests that a single exposure or occasional exposures could be detrimental and result in increased risk of sensitization and development of food allergy. * If an allergen is not a common component of the family’s diet, and regular ingestion is not feasible for that family, avoidance may be preferable to intermittent ingestion although further research is required. * For newborn infants, exclusive breastfeeding is best, but if cow’s milk formula is introduced it should be given regularly (e.g. one feeding per day to supplement breastfeeding) from that point forward rather than intermittently to prevent cow’s milk allergy. * The ideal amount and frequency of regular ingestion remains unknown, but the above recommendation is based on a balance of evidence and practicality.