Babies may eat peanuts, eggs and other potential food allergens as early as six months, Canadian pediatricians say.
Children with a parent or sibling who has a food allergy or another allergic condition like eczema, asthma or hay fever are considered at high risk of developing a food allergy.
On Monday, the Canadian Paediatric Society published a position statement on allergy prevention in high-risk infants that was endorsed by the Dietitians of Canada.
Previously, the message to many parents had been to delay giving high-risk foods to babies.
There's no evidence that delaying the introduction of potential allergens like peanuts, fish or eggs beyond six months helps to prevent allergy, said Dr. Edmond Chan, a pediatric allergist and his team.
"We thought we had good intentions about protection, but ironically we may have generated a rise in food allergy through those [previous] recommendations," Chan said.
The group also advises against avoiding milk, egg, peanut or other foods while pregnant or breastfeeding because there's no evidence that avoiding them helps to prevent allergy and there are risks of maternal undernutrition and potential harm to the infants.
When Stephanie Schick's four-year-old daughter eats yogurt, she gets fully washed down to help protect her six-year-old sister, who has a dairy allergy.
"We did delay with our first born giving the peanuts because we had such a rocky ride with a lot of the other first foods," Schick recalled. "For the first born, that was the message."
Now, the Canadian pediatric group said while these foods can be introduced to high-risk babies, the decision about when should be individualized and based on the parents' comfort level.
Give new foods several times a week
The American Academy of Pediatrics reversed its recommendations in 2008, but Chan said not enough Canadian family doctors and parents have heard about the change.
Once parents introduce a new food to babies, doctors recommend giving it several times per week with a soft mashed consistency to avoid the risk of choking to maintain a child's tolerance.
For example, Chan suggested parents could mix a small amount of peanut butter with a starter food like rice cereal. Or if a parent is apprehensive, they could talk to a pediatric allergist about testing the food at the doctor's office.
Doctors continue to recommend breastfeeding exclusively for the first six months. For mothers who cannot or choose not to breastfeed, pediatricians suggest hydrolyzed cow's-milk-based formula, based on limited evidence.
Food allergies affect about seven per cent of Canadians. Some research from Australia suggests food allergy in babies is increasing, affecting more than 10 per cent of one-year-olds.
Researchers continue to investigate whether introducing potential allergens earlier, at four to six months, has any protective effect.