AAP Amends Its Stance on the Role of Diet in Preventing Allergies in Kids

For many years, the nutrition and allergy experts of the American Academy of Pediatrics (AAP) have given parents advice about how and when they should introduce their tots to certain foods, aiming to reduce kids' risk of food allergies, asthma, and allergic rashes. Based on a recent review of existing research data on the subject, the AAP has issued new guidelines changing some of those currently accepted recommendations.

The long and short of the report: Avoiding certain food allergens from the get-go has been proven to help only those babies with a high risk of food allergies (that is, those with a parent or sibling with allergies). But for everyone else, avoiding known allergens — during pregnancy, breastfeeding, and when introducing foods in the infant and toddler years — hasn't been shown to have much effect on preventing allergies.

The recent, headline-grabbing recommendations are establishing new AAP policy that may confuse parents who've gotten used to following the organization's old dietary do's and don'ts, which most pediatricians have been endorsing for years.

But it's important to note that the AAP isn't just tossing out its old policies. Although the new report does advise changes in some of the guidelines, the AAP's allergy and nutrition expert panels stress that, although current evidence doesn't provide adequate scientific support of some of the existing recommendations, they aren't ready to say those policies have been disproved altogether until they have more reliable research in hand.

Key Points From the Report

The new policy lists the things that current research indicates do seem to work to keep food allergies, asthma, and atopic dermatitis (eczema) at bay — and things that don't.

According to the best available research, feeding only breast milk or certain hydrolyzed formulas (in which the proteins have been broken down to make them less allergenic) for at least 4 months can help prevent or put off atopic dermatitis, cow's milk allergy, and wheezing in early childhood for high-risk kids.

However, a lack of "current convincing evidence" shows that some old recommendations do not seem to help in certain areas:

• Women do not need to avoid eating any potential allergens (like peanuts) during pregnancy or breastfeeding. But the study points out that although more research is needed, there is some evidence that avoiding certain foods while nursing could possibly help prevent eczema.
• Exclusive breastfeeding does not seem to protect against allergic asthma that starts beyond early childhood (after 6 years of age).
• Feeding soy-based infant formulas does not seem to help prevent allergies.
• From an allergy prevention standpoint, there's no reason to wait beyond 4 to 6 months of age to start babies on solid foods.

What This Means to You

If you're still perplexed about the new recommendations, consider these standard dietary tidbits that can help you start your tiny tot off on the right nutritional foot: