July 16 2012 - ASCIA Infant Feeding and Maternal Diet Advice
Recent media reports regarding an association between breastfeeding and parent-reported nut allergy may cause confusion amongst parents. The Australasian Society of Clinical Immunology and Allergy (ASCIA) would like to clarify that no changes to infant feeding or maternal diet should be made based on these reports.
ASCIA Infant Feeding Advice (available on the ASCIA website http://www.allergy.org.au/health-professionals/papers/ascia-infant-feeding-advice) remains as follows:
- Breastfeeding is recommended for at least 6 months for many reasons and is encouraged for as long as the mother and infant wish to continue.
- Excluding allergenic foods from the maternal diet is not recommended as there is no evidence that this prevents allergies.
- Introducing complementary solid foods from around 4-6 months, whilst still breastfeeding, is supported by current evidence published in peer reviewed journals affiliated with professional paediatric and allergy/immunology medical organisations. Giving one new food at a time is advised and if a food is tolerated, continue to give this as a part of a varied diet. If there is any reaction to any food, you should seek medical advice and that food should be avoided until your child is reviewed by a medical practitioner with experience in food allergy.
A recently published research article in an open access journal (International Journal of Pediatrics) concluded that children were at increased risk of developing a parent-reported nut allergy if they were breast fed in the first six months of life. It also stated that there was a positive association between parent reported nut allergy and having a regular general practitioner (GP).
Recent media reports that breastfeeding and having a regular GP cause or increase the risk of nut allergy, that were based on this article, are unreliable for the following reasons:
- The parent-reporting of nut allergy in this article is retrospective and there is no medical confirmation to substantiate peanut or tree nut allergy.
- The findings are most likely to be entirely accounted for by reverse causation, where parents with a family history of allergic disease (a known factor to increase the risk of developing allergy) will tend to breast feed for a longer period of time, which is the best current advice.
- The article does not include adequate controls for known confounders of atopic disease including family history of allergic disease, smoking, maternal education and birth order.
- Having a regular GP cannot in any way cause or increase the risk of nut allergy. It is appropriate and recommended that patients with symptoms that are suspected to be caused by food allergy see their GP and in some cases the GP will refer them to a Specialist Immunology/Allergy physician for further investigations.
The International Journal of Pediatrics is an open access journal that does not state any affiliation with a professional paediatric or allergy/immunology medical organisation. There is no reference to any Specialist Immunology/Allergy physicians being involved in this research and ASCIA was not aware of this article until Thursday 12 July 2012, when stories appeared in the media.