The Australasian Society of Clinical Immunology and Allergy Limited (ASCIA) was established in 1990 as the peak professional body of clinical immunology and allergy in Australia and New Zealand. The ASCIA infant feeding guidelines [1] recommend introducing foods according to what the family usually eats, regardless of whether the food is considered to be a common food allergen, at around 4-6 months of age. Nut butters, pastes and flours can be introduced at this time, just like other foods. Hold off on whole nuts or nut pieces until around five years to reduce the risk of choking.

Previously, it was recommended to delay the introduction of nuts until around 12 months of age to reduce the risk of allergies. However, there is little evidence to suggest that this can prevent allergies, and in fact may actually have the opposite effect [1-3].  

Recommendations are now that all babies should be given common allergy causing foods by 12 months, including egg and peanut in an age appropriate form such as well-cooked egg and smooth peanut butter/paste. Delaying the introduction of these foods has been shown to increase the chance of developing food allergy [1].  This includes babies who have severe eczema, another food allergy, or a family member with food allergy, even though they may have a higher chance of developing food allergy.

References

  1. ASCIA. Guidelines: Infant feeding and allergy prevention. ASCIA 2016. http://www.allergy.org.au/patients/allergy-prevention/ascia-guidelines-for-infant-feeding-and-allergy-prevention.
  2. Koplin, J.J., et al., Can early introduction of egg prevent egg allergy in infants? A population-based study. J Allergy Clin Immunol, 2010. 126(4): p. 807-13.
  3. Du Toit, G., et al., Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol, 2008. 122(5): p. 984-91.
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