Eat Like Your Ancestors: A Review of Infant Feeding Practices
Around the 1960s, infants began eating food at just a few months of age, and food allergy prevalence was very low. Learn why today's infants should "eat like their ancestors."
The guidelines on introducing allergens have shifted with breakthrough research on food allergen introduction. This shift is remarkable because of its underlining impact on the state of food allergies today and how early allergen introduction can now help solve this new troubling wave of food allergies. When we review infant feeding practices in recent decades, a few key findings emerge:
- Our parents and grandparents began feeding us food at 2 months of age (circa 1960), and back then food allergy prevalence was very low
- Recent trends to feed babies at a later age, and introduce allergens as late as 3 years, have contributed to the dramatic 2-3X rise in food allergies
- We now know that delaying allergen introduction increases a child’s risk by 4X for developing a food allergy
The Rise of Food Allergies
Now more than 1 in 10 suffer from a food allergy in the US with the rates of peanut allergy tripling in recent years. While there are many theories on why food allergies have reached epidemic proportions, there is strong evidence to support that previous (now outdated) recommendations to delay allergen introduction have contributed to this troubling trend. In fact, a recent JACI study reveals that delaying peanut introduction can put your child at up to a 7x higher risk of developing a peanut allergy.
A Retrospect on Food Introduction Guidelines
Sources: 1. Harris LE, Chan JC. Am J Dis Child 1969;117(4):483-92., 2. Challacombe DN. Arch Dis Child 1983;58(5):326., 3. GrimshawKE, Allen KJ et al. Allergy 2009;64(10):1407-16, 4. American Academy of Pediatrics. Pediatrics 2000;106:346-9
As indicated above, there has been a progressive delay in our recommendations on the timing of introduction of solid foods (including allergenic foods) in recent decades. And when we look back at when solids were introduced earlier in infancy in the 1960s, the prevalence of food allergies was very low and with that, the rate of serious food allergic reactions was even more scarce. But in the aftermath of this shift in guidelines, food allergy rates have increased significantly coupled with the steep rise of anaphylaxis-related ER visits, according to recent BCBS findings below.
Food Allergy Patterns Around the World
Additionally, there is emerging evidence that there is a wide variance in food allergy prevalence globally. For instance, the overall prevalence of food allergy in children below 5 years of age is only 1% in Thailand, but as high as 5.3% in Korean infants and 10% in Australian pre-schoolers, according to a 2018 study.
While there is still very limited evidence on food allergy rates by country, it has been observed that many factors play in role in determining food allergy prevalence including climate, migration patterns and most notably, infant feeding practices as indicated below:
“Changes in infant feeding practices over the past 2 decades have been postulated to be partly responsible for the exponential rise in food allergy rates. In the year 2000, the World Health Organization (WHO) recommended that complementary foods be introduced no earlier than 6 months of age. The American Academy of Pediatrics (AAP) further recommended maternal restriction of peanuts and tree nuts, and the elimination of cow's milk, eggs, and fish during lactation to reduce the risk of food allergy in their offspring. It also recommended that solid foods not be introduced into the diet of high-risk infants until 6 months of age and dairy products delayed until 1 year, eggs until 2 years, and peanuts, nuts, and fish until 3 years of age.56 However, as evidence for delayed allergenic food introduction for food allergy prevention was lacking, the AAP & the National Institute of Allergy and Infectious Diseases (NIAID) subsequently replaced these guidelines with new recommendations that solid foods not be delayed beyond 4–6 months of age and that the introduction of allergenic foods into infants' diets should no longer be delayed.” - "How Different Parts of the World Provide New Insights Into Food Allergy", Allergy, Asthma & Immunology Research, 2018
A Closer Look and Key Lessons
When we look back historically on food allergy rates and the progressive delay in infant (allergenic) food introduction, there are three key lessons for parents to consider:
- Introducing allergenic foods starting at 4 months of age, is supported by new research, AAP guidelines and historical data,
- There is strong evidence to support that introducing allergenic foods earlier and in infancy is safer and contributes to less severe reactions than by delaying introduction.
- Early and sustained allergen introduction starting at 4 months of age is the solution to reversing the troubling rise in food allergies
Ready, Set, Food! can help you follow the new clinical recommendations. Join us in our mission to give families everywhere a lifetime of food freedom.
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.
These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease. If your infant has severe eczema, check with your infant’s healthcare provider before feeding foods containing ground peanuts.