delaying weaning and allergies - where is the evidence(7 Posts)
by delaying, I mean waiting till 6 months, so not really delaying, but I couldn't find a better phrase
I have family history of eczema, and dt1 now has baby eczema. I want to do everything possible to avoid aggravating it. I don't plan to wean before 6 months, but when I do, should we avoid certain foods or not? and is waiting till 6m related solely to immature gut or allergies also?
I did search on pubmed but failed to find anything clear and relevant [overtired]
IIRC waiting to 6 months isn't related to allergies -- weaning before 4 months is associated with a higher incidence of allergies than weaning after 6 months, but weaning between 4-6 months doesn't appear to be associated with a higher incidence of allergies than weaning after 6 months.
I think there's a big study running at the moment looking into this; MN had a leading allergist on for a webchat last year or the year before and I remember its coming up then.
Delaying weaning until 6 months is to do with preventing infections. As previous poster said, currently the evidence does not show that weaning between 4-6 months increases the risk of allergies.
Here's the webchat thread (may well be of interest to you in general)
He summed up the weaning-age-related-to-allergies points at Wed 19-Nov-08 09:15:49:
"Current best evidence suggest exclusive breast feeding up to 4 months protects against allergic disease. Of course, prevention of allergic disease is not the only reason to breastfeed and many other benefits have informed the WHO advice to advocate exclusive breastfeeding to 6 months. It would, however, be inaccurate to claim that exclusive breast feeding beyond 4 months has been shown to help prevent allergies. There is also evidence to suggest that early introduction of solids (prior to 17 weeks) is associated with higher risk of allergies but this is not based on cast iron data, just the best available. There is mounting evidence that early oral exposure (i.e. <17weeks) to allergenic food proteins may actually help prevent food allergy. In order to get to the truth, an interventional study is needed, which is what I was alluding to. The study will compare those who introduce solids from 3 months to those who delay introduction to see the effect on development of food allergy. This will hopefully shed more light on what the best weaning advice should be. I hope this clarifies things a little but weaning and it's impact on allergic disease is a difficult area and we know very little for definite. You mentioned 'guilt and fear' which many mums definitely feel. However, even exclusive breastfeeding doesn't by any means prevent all allergic disease - you can't change your genes!, and at best can only hope to shift the odds slightly more in favour of less allergies."
When DS was born, familes with allergies were advise to wean after 6m, now everybody is given that advice.
I have found some guidelines on when to introduce the most common allergens to a baby with an allergic background (long after my baby had eaten all of them but nuts and was already a walking allergy catalog). TBH I think they have changed these recommendations over the last couple of years (again)... so... the reality is that nobody knows for sure. Some people think that late introduction helps to reduce the risk, other are sure that late introduction makes the problem worse.
If I had another baby, the only thing that I would be careful with would be egg and nuts, he wouldn't have any egg until at least 12m and no nuts for a good longer than that. But only if it was like DS, whose eczema was so bad I had to peel him of the cot's sheets most mornings.
very interesting webchat.
I do not understand how delayed introduction of foods can help prevent allergy, but I have a rather cartoon understanding of immunology, and particular its early development. it's a shame the studies are only running now - no results in time to help inform me for weaning! [completely selfish]
dt1 has skin like me - dry, flaky - and now with the baby eczema, I fear she will share my eczema too. my triggers tho aren't eggs or nuts - everyone in our family who has eczema shares chocolate, some also dairy - so should I still consider delaying these?
Read this from the European Society for Paediatric Gastroenterology Hepatology and Nutrition about weaning and allergies - says that no scientific evidence that avoidance or delayed introduction of food reduces risk of allergies in infants considered at risk. Also says complementary foods should be introduced no earlier than 17 weeks and no later than 26 weeks.
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