Evaluation of the introduction of allergen-containing foods

Food allergen introduction patterns in the first year of life: A US nationwide survey

“…In our survey, the converse was also true: among caregivers who introduced egg before 7 months and before 1 year, 46.4% and 67.8% also introduced peanut, respectively. However, this was much lower in the study by Groetch et al, 19 These authors noted that only 2.3% of children consuming egg by 6 months and 9.3% of children consuming egg by 12 months, also consumed peanut‐containing foods by 6 months.…”

“…While these observed rates of peanut introduction appear low in the context of recently published guidelines recommending that all infants consume peanut during the first year of life, they nevertheless mark a substantial increase from 2016 data collected in the Feeding Infants and Toddlers Study (2016), a US population‐based study, surveying caregivers of 3235 infants in the US. In this landmark infant nutrition study, 19 0.3% of caregivers/caregivers reported introducing peanut to their infant by 4–5.9 months, 0.9% by 6–8.9 months, and 5.5% by 9–11.9 months. In our study 5.5% of caregivers fed infants peanut before 7 months and 44.7% before 13 months.…”

“…In our study, of those who introduced peanuts before 13 months, 76.5% also introduced egg. Groetch et al 19 noted that only 60.5% of children consuming peanut by 12 months, also consumed egg‐containing foods by 12 months. In our survey, the converse was also true: among caregivers who introduced egg before 7 months and before 1 year, 46.4% and 67.8% also introduced peanut, respectively.…”

“… 9 However, caregivers' approach to introducing peanut safely to their children is questionable considering most did not report thinning peanut butter with water before feeding to avoid infant choking as advised by the AAP. 27 It remains unclear which forms of peanut young children in the US regularly consume as peanut intake measured by questionnaire is often described in a combined category of “nuts, seeds, and legumes” in federal surveys 27 and infant feeding studies 19 , 28 Currently most validated food recall measures in the US such as the ASA‐24 29 and the Diet History Questionnaire (DHQ) 30 do not clearly distinguish between different forms of nuts and seeds eaten, which poses a practical challenge for food allergy research, where understanding the quantity, frequency and format in which specific allergenic solids are consumed are crucial.…”

“…This is in contrast with most other nutritional studies, which focus on assessing nutritional intake with no targeted questions on the consumption of allergenic solids. 19 , 28 Due to our reliance on caregiver‐reported dietary recall measures, assessed cross‐sectionally, our study is subject to their inherent limitations, most notably recall bias. We also note one possible limitation.…”