Guide to BSACI Guidelines for Food Allergy Prevention – Ready, Set, Food!
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BSACI Guidelines for Food Allergy Prevention: What Families Need to Know

Learn about how 2018 food allergy prevention guidelines from the British Society of Allergy and Clinical Immunology (BSACI) recommend early, consistent introduction of allergy-causing foods to reduce your baby’s food allergy risk.

In 2018, the British Society for Allergy and Clinical Immunology (BSACI) released their "Preventing food allergy in your baby: A summary for parents." These guidelines are based on evidence from landmark clinical studies on food allergy prevention. In particular, they're based on the landmark LEAP (Learning Early About Peanut Allergy) and EAT (Enquiring About Tolerance) studies.

Notably, the 2018 BSACI guidelines recommend introducing common allergy-causing foods (like peanut and egg) to babies as early as 4-6 months of age, to help reduce their risk of developing allergies to these foods.

Today, we'll cover the key points that your family should take away from the BSACI guidelines, to help give your baby the best defense against food allergies.

What Families Need To Know About The BSACI Guidelines 

  1. Introduce Allergy-Causing Foods Early and Consistently

The BSACI guidelines recommend introducing babies to allergy-causing foods, like egg and peanut, as early as 4-6 months, for the best chance of preventing later food allergies. 

They also recommend "continu[ing] to feed baby these foods regularly as part of their usual diet," as "this may help reduce the chance of their developing an allergy to [those foods] later."

The BSACI guidelines are based on the landmark LEAP and EAT studies, which have shown that consistently introducing peanut and egg within baby's first year of life significantly reduces their risk of developing allergies to these foods.

Here's a short breakdown of the LEAP and EAT studies:

  • In the LEAP study, babies at high risk for peanut allergy were randomly assigned to either consume peanut protein regularly as early as 4 months of age, or avoid peanut protein until 5 years of age.
    • The study showed an 80% reduction in the risk of developing a peanut allergy in the group of children who consumed peanut protein early and often.

 Learn more about the LEAP trial from this 1-minute video from the New England Journal of Medicine:

  • In the EAT study, babies at lower risk for food allergy either ate six common allergy-causing foods consistently for 3-6 months, or avoided these foods completely for at least 6 months. 
    • The study showed a 67% food allergy reduction risk in the group
      that consistently ate the common allergy-causing foods.
  • Both the LEAP and EAT studies also showed that introducing allergy-causing foods before one year is safe, and that when allergic reactions do occur, they tend to be mild.

Thus, there is strong evidence that introducing allergens like peanut and egg to babies, starting as early as 4-6 months, may help reduce their risk of developing food allergies by up to 80%. 

   2. Introduce Allergy-Causing Foods Earlier If Your Baby Is At        Higher Risk

If your baby is at higher risk for food allergies, the BSACI guidelines recommend starting allergen introduction earlier.

As the BSACI guidelines state, babies with eczema, or any existing food allergy, are at higher risk for food allergies. The more severe a baby's eczema is, the higher their risk for an allergy.

  • Babies in this risk category should be introduced to egg, peanut and other common allergy-causing foods (that they aren't already allergic to) starting at 4 months of age.
  • Parents should introduce these foods in an age-appropriate form, to reduce choking risk.
  • Introduce one new food at a time, and monitor for signs of an allergic reaction.
  • Introduce allergy-causing foods gradually (start with a smaller amount, and slowly increase the amount you feed baby.)
  • Parents should prioritize peanut and egg introduction, and introduce cooked egg before they introduce peanut. 

Babies without eczema, and without an existing food allergy, are at lower food allergy risk.

  • These babies should be introduced to allergy-causing foods, like peanut, egg, milk, wheat, seafood and tree nuts, starting around 6 months of age.
  • Parents should introduce these foods in an age-appropriate form, to reduce choking risk.
  • Introduce one new food at a time, and monitor for signs of an allergic reaction.
  • Introduce allergy-causing foods gradually (start with a smaller amount, and slowly increase the amount you feed baby.)
  • Introduce common allergy-causing foods into your baby's diet before they turn one year of age.

If A Family Member Has A Food Allergy

In the BSACI guidelines, babies who have a family member with a food allergy at home are still considered "lower risk" if they don't have a food allergy of their own, and if they don't have eczema.

These babies should still be introduced to allergy-causing foods as early as 6 months of age. Parents should not delay this introduction beyond one year of age, even if they have concerns about a food. This is because deliberately delaying the introduction of a food can increase the risk of developing an allergy to that food.

Still, parents will have to plan how to carefully introduce allergy-causing foods to their baby, while keeping the person with the food allergy safe.

If Your Baby Has Eczema

If your baby has eczema, the BSACI guidelines recommend making sure their eczema is well-controlled. This way, you can better determine if your baby develops a skin-related allergic reaction to a food.

If your baby's eczema gets worse after feeding them a common allergy-causing food, stop feeding your baby that food and consult a specialist. 

  3. Food Allergy Screening Is Not Needed Prior To Early Introduction

According to the BSACI guidelines, babies don't need to be screened for food allergies before you start early introduction. This applies even if your baby is at higher risk for a food allergy. 

Availability of allergists to conduct a screening can be limited, and the wait for a screening can be long. So, waiting for a screening before starting early introduction may increase a baby's risk of developing a food allergy.

"The benefits of allergy testing in higher risk babies before introducing egg or peanut needs to be balanced against the risk this could cause a delay (due to lack of available testing) and increase the risk of food allergy." ---BSACI Guidelines, Summary for Parents

Key Takeaways From The Guidelines

  1. The BSACI guidelines recommend early and consistent introduction of allergy-causing foods, to reduce your baby's food allergy risk. 
  2. Early and consistent introduction is vital for all babies, regardless of food allergy risk. 
  3. Babies at high risk for food allergies should start eating common allergy-causing foods at 4 months of age.
  4. Babies at lower risk for food allergies should start eating common allergy-causing foods as early as 6 months of age, and before one year of age.
  5. Even if your baby is at high risk for food allergies, they do not need an allergy screening before starting early introduction.

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All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.

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About Mike Reynoldson: Mike Reynoldson is the CFO/COO for Ready, Set, Food!

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