AAAAI Food Allergy Prevention Guidelines: 5 Things Every Parent Should Know

For many, food allergies appear early on in life and continue well into adulthood. 

In the past, medical advice stated that foods with a high risk of an allergic reaction should be avoided. As a result, the prevalence of peanut allergies in U.S. children has at least doubled from 1997 to 2008.

However, in recent decades more and more research has shown that the earlier these foods are presented to our babies, the better. In this article you will learn more about the AAAAI guidelines and how they impact babies with food allergies.

“To prevent peanut and/or egg allergy, peanut and egg should be introduced around [4-]6 months of life.”

- AAAAI, ACAAI, and CSACI

The AAAAI and other leading allergy organizations released new guidelines designed to help parents prevent their babies from developing food allergies to reflect these findings. In this article, we'll guide you through the five key takeaways you need to know from the AAAAI guidelines. 

Who are these leading allergy organizations?

AAAAI: The American Academy of Allergy, Asthma & Immunology. a worldwide organization that pools the knowledge of over 7,000 allergists and immunologists. Together, they are dedicated to advancing the knowledge within these areas to ensure allergy and immune disorder patients receive the best possible care. 

ACAAI: Another leading allergy institution is the American College of Allergy, Asthma, and Immunology. Also known simply as the ACAAI, this Illinois based organization is composed of 6,000 allergists-immunologists and allied health professionals. In addition to becoming a medical doctor, members of this organization go through additional, extensive training.

CSACI: In addition to the other leading organizations, the Canadian Society for Allergy and Clinical Immunology needs to be mentioned here. The CSACI was founded in 1945 and continues to improve the standards of teaching and practice of allergy and clinical immunology.

Food Allergies: An Overview 

A food allergy occurs when the body misinterprets certain foods as a threat. Exactly what causes the immune system to wrongly identify a food protein is unknown. 

The number of food allergies among children has increased in recent decades. It is now believed that 1 in every 13 children in the US has a food allergy. The reasons for this increase are still up for debate. However, many medical professionals now believe that a delay in introducing new foods to our children could be to blame. Other possible causes suggested are: 

• environmental changes

• our extreme levels of hygiene

• Vitamin D deficiency

Why have the Food Allergy Prevention Guidelines changed?

As recently as 2000, the American Academy of Pediatrics (AAP) recommended delaying feeding allergenic foods. They believed that a delay could prevent the development of food allergies. This advice was then adopted by medical professionals and parents around the world. 

In 2008, that changed. The AAP published a report stating that the evidence for this finding was insufficient. They couldn't find any scientific reason to delay feeding these foods after just 6 months of age. 

Since, the AAP has conducted further research and published an update in 2019. This update stated there was no evidence to suggest that waiting until an infant was 4-6 months old prevented the development of allergies. This conclusion likely came off the back of other studies, such as the LEAP study on food allergy prevention. So, what do the new guidelines include that you need to know? 

AAAAI Guidelines: 5 Key Takeaways for Parents

1. Early introduction of highly allergenic foods can prevent food allergies in babies

The new AAAAI guidelines say that to prevent your baby from developing a food allergy, highly allergenic foods should be introduced from as early as 4 months. This includes foods like peanuts, and eggs. They advise you to introduce these foods gradually into your child's diet until they become a staple. 

Clearly, this is a huge departure from the advice given by the AAP in 2000. Over the last two decades, research has shown that delaying the introduction of allergens to your baby can, in fact, increase the risk of developing a food allergy. Introducing them early can help prevent a food allergy. 

How should I implement this into my child's diet? 

Common allergens should be introduced to your child cautiously and gradually, once they reach 4 months old. Start with one and feed little and often. For example, the SPADE study saw a reduction in the number of cow's milk allergies within their study group after feeding just 10ml per week for a year, spread out into 2-3 feedings over the week. 

For foods like peanuts, where serving it whole is a choking hazard, look to alternatives like peanut butter, peanut puffs or early allergen introduction systems.

2. Early allergen introduction is recommended for all babies

AAAAI advises that it is not necessary to pre-screen babies for allergies. However, they do acknowledge that it may be preferable for some families. 

“Eczema is considered the highest risk factor for developing IgE-mediated food allergy, but children without risk factors still develop food allergy.”

“Children without risk factors still develop food allergy.”

- AAAAI

3. You don’t need to avoid highly allergenic foods when pregnant or breastfeeding

Historically, medical professionals advised pregnant and breastfeeding women to avoid highly allergenic foods. However, this is no longer the case. 

The AAAAI guidelines state that there is no benefit in avoiding these foods while pregnant or breastfeeding. Unless the mother is allergic or intolerant, avoiding these foods is not necessary. In fact, many of these foods hold a high nutritional value that is actually of benefit for both mother and baby.

4. Breastfeeding is beneficial, but not in preventing food allergies in babies

Of course, all mothers are encouraged to breastfeed where possible. However, there is no link between being breastfed and the prevention of food allergies. 

This means that parents and babies unable to breastfeed need not worry. In this case, the body's immune response is independent of the nutritional value of their mother's milk. 

Again, you do not need to avoid common allergens as a breastfeeding mother unless your child has a preexisting allergy. 

5. Some factors put babies at a higher risk for developing food allergies

It is possible for an infant with no history or family history of a food allergy to develop one. However, some factors will put your baby at higher risk. Here are the factors the AAAAI identifies in their guidelines: 

• Babies with severe eczema have the highest risk of developing a food allergy

• If either biological parent has a family history of severe allergies 

• Babies with mild or moderate eczema

• Babies with an existing food allergy

Final Thoughts 

These new guidelines show us that it is beneficial to introduce allergenic foods as early as 4 months old to help all babies reduce their risk of developing a food allergy. It also does not directly caution against using the same introductory process for all babies, regardless of risk type. 

With continued research and careful early introduction by parents like you, we can offer our children the best chance at an allergy-free life.

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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.

These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.