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In The Netherlands it is recommended to introduce peanut and egg to babies between 4 and 6 months, to reduce the chances of food allergy. More information (in

In The Netherlands it is recommended to introduce peanut and egg to babies between 4 and 6 months, to reduce the chances of food allergy. More information (in Dutch): https://www.voedingscentrum.nl/nl/service/vraag-en-antwoord/kinderen-en-jongeren/wanneer-geef-ik-mijn-baby-pinda-en-ei.aspx https://www.voedingscentrum.nl/nl/service/vraag-en-antwoord/...

hammock 2y ago
Where does the peanut and egg allergy come from? My understanding is that peanut oil and egg albumin are ingredients in many common medicines given early to infants.. is there any chance that could be contributing?
- User23 2y ago
  It does make you wonder if we shouldn’t vaccinate until exposing the children to solid foods in ordinary healthy cases. The mother’s antibodies from her milk do good work. There are other commenters warning about skin exposure before dietary exposure. If that’s true then it would make sense.
  - hammock 2y ago
    If you say certain words you get downvoted but I’ve found people seem to keep an open mind more if you use words like “medicine” that don’t immediately challenge deeply held beliefs Interesting point about the skin exposure, I’ll go back and review those comments. Evolutionarily/practically i would think it’s tough to get oral exposure to something prior to skin exposure (it hits your mouth/hands/face before your stomach), unless the breastmilk vector you mention is critical
- munchbunny 2y ago
  In short, we don’t know. Egg albumin is also interesting because the vast majority of kids outgrow it. My toddler has a peanut allergy but has already outgrown his egg albumin allergy.
Xeyz0r 2y ago
Didn't know that introducing these foods early in life can help build tolerance
mikeyouse 2y ago
That's the current guidance in the US as well. https://mana.md/peanut-allergies-may-affect-your-child/ https://mana.md/peanut-allergies-may-affect-your-child/
- hammock 2y ago
  How have outcomes improved since the guidance?
  - mikeyouse 2y ago
    There's very strong evidence of the success of this -- for babies with no indication of a peanut allergy, intentional exposure led to an ~85% reduction in allergies -- for those who had a positive allergy test before the study, they had a ~70% reduction in allergies by 5 years old. > Among the 530 infants in the intention-to-treat population who initially had negative results on the skin-prick test, the prevalence of peanut allergy at 60 months of age was 13.7% in the avoidance group and 1.9% in the consumption group (P<0.001). Among the 98 participants in the intention-to-treat population who initially had positive test results, the prevalence of peanut allergy was 35.3% in the avoidance group and 10.6% in the consumption group (P=0.004). There was no significant between-group difference in the incidence of serious adverse events. Increases in levels of peanut-specific IgG4 antibody occurred predominantly in the consumption group; a greater percentage of participants in the avoidance group had elevated titers of peanut-specific IgE antibody. A larger wheal on the skin-prick test and a lower ratio of peanut-specific IgG4:IgE were associated with peanut allergy. https://www.nejm.org/doi/full/10.1056/NEJMoa1414850 https://www.nejm.org/doi/full/10.1056/NEJMoa1414850
- 01100011 2y ago
  and IIRC you need to maintain consistent exposure to the allergens throughout the first, idk, 18 months of life to have the best result. So don't just expose them once early on and stop.
  - t0mas88 2y ago
    Yes that's part of the advice in the Netherlands as well. Keep giving them things that can be common allergies. My 4 year old's favourite food is shrimp and sushi... Not sure whether it's related to her eating those when she was a toddler, but it's fun to see the reactions in restaurants when you don't order the children's menu.
soperj 2y ago
Australia changed their recommendations to match this years ago, and the incidence of allergy didn't change measurably.
- curiousgal 2y ago
  lol did they measure whether people were following the recommendations?
  - soperj 2y ago
    lol yes.
    - s3p 2y ago
      Source?
JumpCrisscross 2y ago
> introduce peanut and egg to babies between 4 and 6 months What goes wrong if they're exposed before that? If the mother eats peanuts and eggs while breast feeding, does that confer desensitisation?
- t0mas88 2y ago
  It's the opposite. Usually babies don't eat any food at 4 months. They only get breastmilk or formula. The advice is to start early with peanutbutter and egg. In our case diary products were an issue instead of nuts. My daughter would get very sick from anything that had diary in it, even if my wife ate diary products while breastfeeding. But at about 1.5 years one she got over that and now at 4 she is completely fine drinking normal cow milk. So allergies in kids are not a permanent set in stone thing. They can get over some, and early exposure makes a difference.
  - lurking_swe 2y ago
    (unrelated) friendly tip: i think you meant dairy. A diary is not edible. :) https://www.merriam-webster.com/dictionary/diary https://www.merriam-webster.com/dictionary/diary
- ecshafer 2y ago
  I am not sure if you had a child or not, but you don't give the baby food before 4 to 6 months. So its not that you aren't exposing them at all, but not feeding them the food.
  - theNJR 2y ago
    There are powders to add to your formula / breast milk to introduce allergens early (we used Ready Set Food but easy to DIY). Kind of annoying since they often clog the nipple of the bottle, but we did it with my daughter who is now 20 months and her favorite breakfast is a spoon of peanut butter. Sesame gives her a slight reaction still, we unfortunately don’t eat it very often.
ascorbic 2y ago
My daughter took part in a large study that led to similar guidance being introduced in the UK. The was randomised into the early introduction group, which meant that she had to eat peanut, egg, cow's milk, fish, wheat and sesame on a regular schedule when she was a baby. It was interesting - though lots of work, and when she was old enough to understand why she was going up to London for the follow-up tests, she was very proud of her role as "scientist". It was very satisfying when the results were published many years later, proving the hypothesis. https://www.food.gov.uk/research/food-allergy-and-intolerance-research/eat-study-early-introduction-of-allergenic-foods-to-induce-tolerance https://www.food.gov.uk/research/food-allergy-and-intoleranc...
- soperj 2y ago
  > Overall, food allergy was lower in the group introduced to allergenic foods early but the difference was not statistically significant. How is that proving the hypothesis?
  - lolinder 2y ago
    Keep reading: > ... Early introduction of all the foods was not easy but it was safe. Among the infants who did manage to consume the recommended quantity of the allergenic foods there was a two-thirds reduction in overall food allergy. > For those who fed their infant the recommended amount of peanut there was a significant reduction in peanut allergy, 2.5% in the standard introduction group compared to no cases in the early introduction group (0%). > There was also a significant reduction for egg allergy- 5.5% in the standard introduction group compared to 1.4% in the early introduction group. In other words, in the group as a whole when considering all food allergies, the difference was not statistically significant, but that can be attributed to a large number of families in the test group failing to actually perform the test. It sounds like when you control for actually following the instructions there is a statistically significant difference in overall food allergy incidence.
    - gmokki 2y ago
      I fail to see how your chosen quotes prove your point. How is 66% reduction not statistically significant?

hammock 2y ago

Where does the peanut and egg allergy come from? My understanding is that peanut oil and egg albumin are ingredients in many common medicines given early to infants.. is there any chance that could be contributing?

User23 2y ago
It does make you wonder if we shouldn’t vaccinate until exposing the children to solid foods in ordinary healthy cases. The mother’s antibodies from her milk do good work. There are other commenters warning about skin exposure before dietary exposure. If that’s true then it would make sense.
- hammock 2y ago
  If you say certain words you get downvoted but I’ve found people seem to keep an open mind more if you use words like “medicine” that don’t immediately challenge deeply held beliefs Interesting point about the skin exposure, I’ll go back and review those comments. Evolutionarily/practically i would think it’s tough to get oral exposure to something prior to skin exposure (it hits your mouth/hands/face before your stomach), unless the breastmilk vector you mention is critical
munchbunny 2y ago
In short, we don’t know. Egg albumin is also interesting because the vast majority of kids outgrow it. My toddler has a peanut allergy but has already outgrown his egg albumin allergy.

Xeyz0r 2y ago

Didn't know that introducing these foods early in life can help build tolerance

mikeyouse 2y ago

That's the current guidance in the US as well. https://mana.md/peanut-allergies-may-affect-your-child/ https://mana.md/peanut-allergies-may-affect-your-child/

hammock 2y ago
How have outcomes improved since the guidance?
- mikeyouse 2y ago
  There's very strong evidence of the success of this -- for babies with no indication of a peanut allergy, intentional exposure led to an ~85% reduction in allergies -- for those who had a positive allergy test before the study, they had a ~70% reduction in allergies by 5 years old. > Among the 530 infants in the intention-to-treat population who initially had negative results on the skin-prick test, the prevalence of peanut allergy at 60 months of age was 13.7% in the avoidance group and 1.9% in the consumption group (P<0.001). Among the 98 participants in the intention-to-treat population who initially had positive test results, the prevalence of peanut allergy was 35.3% in the avoidance group and 10.6% in the consumption group (P=0.004). There was no significant between-group difference in the incidence of serious adverse events. Increases in levels of peanut-specific IgG4 antibody occurred predominantly in the consumption group; a greater percentage of participants in the avoidance group had elevated titers of peanut-specific IgE antibody. A larger wheal on the skin-prick test and a lower ratio of peanut-specific IgG4:IgE were associated with peanut allergy. https://www.nejm.org/doi/full/10.1056/NEJMoa1414850 https://www.nejm.org/doi/full/10.1056/NEJMoa1414850
01100011 2y ago
and IIRC you need to maintain consistent exposure to the allergens throughout the first, idk, 18 months of life to have the best result. So don't just expose them once early on and stop.
- t0mas88 2y ago
  Yes that's part of the advice in the Netherlands as well. Keep giving them things that can be common allergies. My 4 year old's favourite food is shrimp and sushi... Not sure whether it's related to her eating those when she was a toddler, but it's fun to see the reactions in restaurants when you don't order the children's menu.

soperj 2y ago

Australia changed their recommendations to match this years ago, and the incidence of allergy didn't change measurably.

curiousgal 2y ago
lol did they measure whether people were following the recommendations?
- soperj 2y ago
  lol yes.
  - s3p 2y ago
    Source?

JumpCrisscross 2y ago

> introduce peanut and egg to babies between 4 and 6 months What goes wrong if they're exposed before that? If the mother eats peanuts and eggs while breast feeding, does that confer desensitisation?

t0mas88 2y ago
It's the opposite. Usually babies don't eat any food at 4 months. They only get breastmilk or formula. The advice is to start early with peanutbutter and egg. In our case diary products were an issue instead of nuts. My daughter would get very sick from anything that had diary in it, even if my wife ate diary products while breastfeeding. But at about 1.5 years one she got over that and now at 4 she is completely fine drinking normal cow milk. So allergies in kids are not a permanent set in stone thing. They can get over some, and early exposure makes a difference.
- lurking_swe 2y ago
  (unrelated) friendly tip: i think you meant dairy. A diary is not edible. :) https://www.merriam-webster.com/dictionary/diary https://www.merriam-webster.com/dictionary/diary
ecshafer 2y ago
I am not sure if you had a child or not, but you don't give the baby food before 4 to 6 months. So its not that you aren't exposing them at all, but not feeding them the food.
- theNJR 2y ago
  There are powders to add to your formula / breast milk to introduce allergens early (we used Ready Set Food but easy to DIY). Kind of annoying since they often clog the nipple of the bottle, but we did it with my daughter who is now 20 months and her favorite breakfast is a spoon of peanut butter. Sesame gives her a slight reaction still, we unfortunately don’t eat it very often.

ascorbic 2y ago

My daughter took part in a large study that led to similar guidance being introduced in the UK. The was randomised into the early introduction group, which meant that she had to eat peanut, egg, cow's milk, fish, wheat and sesame on a regular schedule when she was a baby. It was interesting - though lots of work, and when she was old enough to understand why she was going up to London for the follow-up tests, she was very proud of her role as "scientist". It was very satisfying when the results were published many years later, proving the hypothesis. https://www.food.gov.uk/research/food-allergy-and-intolerance-research/eat-study-early-introduction-of-allergenic-foods-to-induce-tolerance https://www.food.gov.uk/research/food-allergy-and-intoleranc...

soperj 2y ago
> Overall, food allergy was lower in the group introduced to allergenic foods early but the difference was not statistically significant. How is that proving the hypothesis?
- lolinder 2y ago
  Keep reading: > ... Early introduction of all the foods was not easy but it was safe. Among the infants who did manage to consume the recommended quantity of the allergenic foods there was a two-thirds reduction in overall food allergy. > For those who fed their infant the recommended amount of peanut there was a significant reduction in peanut allergy, 2.5% in the standard introduction group compared to no cases in the early introduction group (0%). > There was also a significant reduction for egg allergy- 5.5% in the standard introduction group compared to 1.4% in the early introduction group. In other words, in the group as a whole when considering all food allergies, the difference was not statistically significant, but that can be attributed to a large number of families in the test group failing to actually perform the test. It sounds like when you control for actually following the instructions there is a statistically significant difference in overall food allergy incidence.
  - gmokki 2y ago
    I fail to see how your chosen quotes prove your point. How is 66% reduction not statistically significant?