Recommendations

Australasian Society of Clinical Immunology and Allergy

5.
Don’t delay introduction of solid foods to infants - ASCIA Guidelines for Infant Feeding and allergy prevention recommend introduction of solid foods to infants, around 6 months of age.

This recommendation is consistent with ASCIA Guidelines for infant feeding and allergy prevention (2016), which recommend introduction of solid foods to infants, at around 6 months of age, but not before 4 months (including foods considered to be highly allergenic such as peanut) preferably whilst breast feeding.

It is important to seek medical advice if an allergic reaction occurs and also regarding the safe introduction of foods if an infant has a sibling or parent with food allergy.

This recommendation is also consistent with findings from recent studies, including the LEAP (Learning Early About Peanut Allergy) trials published in the New England Journal of Medicine (NEJM) in 2015 and 2016. The LEAP trials concluded that the early introduction of peanuts significantly decreased (by 80%) the frequency of the development of peanut allergy among children at high risk for this allergy and modulated immune responses to peanuts.

For further information go to www.allergy.org.au/patients/allergy-prevention

Supporting evidence
  • Du Toit G et al. Effect of avoidance on peanut allergy after early peanut consumption. N Engl J Med. 2016. DOI: 10.1056/NEJMoa1514209
  • Du Toit G et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015 Feb 26;372(9):803-13
  • Perkin MR et al. Randomised trial of introduction of allergenic foods in breast-fed infants. N Engl J Med. 2016. DOI: 10.1056/NEJMoa1514210
  • Togias A et al Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases (NIAID) sponsored expert panel. WAO J 2017 10(1):1. www.ncbi.nlm.nih.gov/pmc/artic... PJ, Campbell DE. Implementing primary prevention for peanut allergy at a population level. JAMA 2017 Feb 13. www.jamanetwork.com/journals/j...
How this list was made How this list was made

The RACP Strategic Policy and Advocacy group assisted ASCIA in compiling the original list of 25 tests, treatments and services, that have been identified either in past work by ASCIA, other literature reviews or in evidence reviews performed by overseas specialist physician bodies or health agencies as being overused, inappropriate or of limited effectiveness.

Two electronic surveys were sent to ASCIA members who are Fellows of the RACP (256 members in total) in February 2015 and March 2015, to firstly rank a top 5 from the list of 25, and secondly to review the wording and rankings of the top 5 recommendations. The overall response rate for these surveys was 20%. All ASCIA members and relevant patient organisations were then invited to review the list.