Am Fam Physician. 2015 Sep 15;92(6):523-524.
Does early introduction of solid foods (added when breast milk or formula is no longer used exclusively) affect the incidence of atopic eczema in childhood?
In most children, solid foods may be introduced before four to six months of age without increasing the risk of atopic eczema. (Strength of Recommendation [SOR]: B, based on prospective cohort trials.) Children with HLA genotypes that predispose them to type 1 diabetes mellitus may be more likely to develop atopic eczema if five or more foods are introduced before six months of age. (SOR: C, based on a single cohort study.)
Evidence suggesting that early introduction of solid foods does not increase the incidence of eczema comes from two large prospective cohort studies that relied heavily on parental recall.1,2 The first was a four-year study (n = 6,905 infants) in which parents used validated questionnaires to report when common food allergens were introduced and whether their child had been diagnosed with eczema.1 By four years of age, children who had been exposed to potential allergens before six months of age did not have an increased risk of eczema compared with exposure after six
REFERENCESshow all references
1. Tromp II, Kiefte-de Jong JC, Lebon A, et al. The introduction of allergenic foods and the development of reported wheezing and eczema in childhood: the Generation R Study. Arch Pediatr Adolesc Med. 2011;165(10):933–938....
2. Zutavern A, Brockow I, Schaaf B, et al.; LISA Study Group. Timing of solid food introduction in relation to eczema, asthma, allergic rhinitis, and food and inhalant sensitization at the age of 6 years: results from the prospective birth cohort study LISA. Pediatrics. 2008;121(1):e44–e52.
3. Sariachvili M, Droste J, Dom S, et al. Early exposure to solid foods and the development of eczema in children up to 4 years of age. Pediatr Allergy Immunol. 2010;21(1 pt 1):74–81.
4. Nwaru BI, Takkinen HM, Kaila M, et al. Food diversity in infancy and the risk of childhood asthma and allergies. J Allergy Clin Immunol. 2014;133(4):1084–1091.
5. Greer FR, Sicherer SH, Burks AW; American Academy of Pediatrics Committee on Nutrition; American Academy of Pediatrics Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008;121(1):183–191.
6. Fleischer DM, Spergel JM, Assa'ad AH, Pongracic JA. Primary prevention of allergic disease through nutritional interventions. J Allergy Clin Immunol Pract. 2013;1(1):29–36.
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