Introduction The Australasian Society of Clinical Immunology and Allergy, the peak professional body for clinical immunology and allergy in Australia and New Zealand, develops and provides information on a wide range of immune‐mediated disorders, including advice about infant feeding and allergy prevention for health professionals and families. Guidelines for infant feeding and early onset allergy prevention were published in 2016, with additional guidance published in 2017 and 2018, based on emerging evidence. Main recommendations When the infant is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods. (This is not a strict window of introduction but rather a recommendation not to delay the introduction of solid foods beyond 12 months.) Introduce peanut and egg in the first year of life in all infants, regardless of their allergy risk factors. Hydrolysed (partially and extensively) formula is no longer recommended for the prevention of allergic disease. Changes in management a result of the guidelines The guidelines specifically recommend introducing solid foods at around 6 months of age and introducing peanut and egg in the first year of life in all infants to prevent allergy development. Hydrolysed formula is no longer recommended for prevention of allergic disease. A new document outlining the reasons for and the method of peanut introduction to high risk infants is available for health professionals.

No abstract

The majority of children with IgE-mediated allergy to egg were able to tolerate 1 g of baked egg protein, but the outcome of OFC remained unpredictable, and 14% of children who failed OFC reacted with anaphylaxis. We recommend that OFC to baked egg should take place under medical supervision.

A SPT of < 2 mm to muffin had a high negative predictive value to baked egg challenge. Ovomucoid SPT ≥ 11 mm was very likely to predict a reaction to baked egg. In these children, deferring the challenge would be appropriate.