Recommendations to Prevent Allergies in Infants


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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 Jan;121(1):183-91.

The AAP policy (link to full article above) published in Pediatrics January 2008, was written after finding that delaying the introduction of solid foods, did not lead to fewer food allergies in children at risk for developing allergies based on family history.

The new guidelines only recommend that solid foods not be introduced before 4 to 6 months of age. After 4 to 6 months of age, there is not enough data to support dietary intervention (restriction).  The recommendations to delay introduction of any food to an older age has been proven ineffective.

There is too little evidence to support that diet alteration among pregnant or breastfeeding moms can cause or prevent a child's allergy (example.- eating peanuts during pregnancy does not seem to cause increased peanut allergy). 

Main points of recommendations

  • There is not enough evidence that maternal dietary restrictions during pregnancy play a significant role in preventing atopic disease in babies (asthma, allergic rhinitis, food allergies, eczema).  There is also a lack of evidence that avoidance of more common allergenic (peanut, tree nuts etc.) foods during breastfeeding prevents atopic disease.
  • For high-risk babies (those with parents or sibling that has an allergic disease), there is evidence that exclusive breastfeeding for at least four months decreases incidence of eczema and cow's milk allergy in the first two years of life.
  • There is evidence that exclusive breastfeeding for at least 3 months protects against wheezing in early life, but an effect on the prevention of asthma in children greater than 6 years is not convincing.
  • For high-risk infants who are not breastfed, there is moderate evidence that eczema may be delayed or prevented by the use of extensively hydrolyzed formulas (such as Alimentum®, Nutramigen® or Pregestimil®) or partially hydrolyzed formulas (for example, Good Start® is partially hydrolyzed whey; Gentlease® is partially hydrolyzed casein) in comparison to cow's milk-based intact formulas. Extensively hydrolyzed formulas may be more effective in the prevention of atopic disease. More research is needed to see if these benefits extend into later childhood and adolescence.
  • There is NO evidence for the use of soy for the prevention of allergy.
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