[Early introduction of potentially allergenic foods in pediatric patients under six months of age]

Rev Alerg Mex. 2023 Apr 19;69(4):183-194. doi: 10.29262/ram.v69i4.1132.
[Article in Spanish]

Abstract

Objective: To review the available evidence on the early introduction of allergenic foods and the possible protection in the development of food allergy in later stages.

Methods: An exploratory review of randomized clinical trials whose study population included infants less than 6 months of age at enrollment with or without a diagnosis of food allergy was conducted. For the purposes of this review, eggs, peanuts, and wheat were included as potentially allergenic foods. The following databases were consulted: Medline, EBSCO, OVID, Science Direct and JSTOR (Journal Storage), Scielo, LILACS, Redalyc and Imbiomed from August to December 2021.

Results: 429 articles were identified, 412 were excluded, and the final analysis included 9 studies that met the inclusion criteria. Six trials correspond to allergy to eggs, two to peanuts and one to wheat. The age of introduction differs in all trials. The earliest exposure was at 3.5 months and the latest at 5.5 months. The reduction in the risk of developing food allergy occurred in children at risk of allergy. Adverse reactions were common, particularly with the introduction of egg.

Conclusions: We found no evidence that early introduction (< 6 months of age) of allergenic foods reduces the risk of developing food allergy in infants without risk factors.

Objectivo: Revisar la evidencia disponible acerca de la introducción temprana de alimentos alergénicos y la posible protección en la aparición de alergia alimentaria en etapas posteriores.

Métodos: Se realizó una revisión exploratoria de ensayos clínicos aleatorizados, cuya población de estudio incluyera lactantes menores de 6 meses al momento del reclutamiento con o sin diagnóstico de alergia alimentaria. Se incluyeron como alimentos potencialmente alergénicos el huevo, cacahuate y trigo. Se consultaron las bases de datos: Medline, EBSCO, OVID, Science Direct y JSTOR (Journal Storage), Scielo, LILACS, Redalyc e Imbiomed del mes de agosto a diciembre de 2021.

Resultados: Se identificaron 429 artículos, se excluyeron 412 y el análisis final incluyó 9 estudios que cumplieron con los criterios de inclusión. Seis ensayos corresponden a alergia al huevo, dos al cacahuate y uno a trigo. La edad de introducción difiere en todos los ensayos. La exposición más temprana fue a los 3.5 y la más tardía a los 5.5 meses. La reducción del riesgo de alergia alimentaria se presentó en niños con riesgo de alergia. Las reacciones adversas fueron comunes, particularmente con la introducción de huevo.

Conclusiones: No existe evidencia que la introducción temprana (< 6 meses de edad) de alimentos alergénicos reduzca el riesgo de alergia alimentaria en lactantes sin factores de riesgo.

Keywords: Complementary feeding; Food Allergy; Infants.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Allergens / adverse effects
  • Arachis
  • Eggs / adverse effects
  • Food Hypersensitivity* / epidemiology
  • Humans
  • Infant
  • Randomized Controlled Trials as Topic

Substances

  • Allergens