Food, drug, insect sting allergy, and anaphylaxisCan early introduction of egg prevent egg allergy in infants? A population-based study
Section snippets
Design and recruitment
The HealthNuts study’s methods have been detailed previously.17 In brief, 11- to 15-month-old infants were recruited as they attended 131 council-run immunization sessions across Melbourne, Australia, between June 2008 and January 2010. At the commencement of the study, statewide policy was to not introduce solids until 6 months of age and egg until 10 months of age. More than 90% of Melbourne infants receive their 12-month immunizations, with approximately half of these attending council-run
Study population
Of 3552 infants eligible for participation who were approached at immunization clinics, 2589 (73%) participated. Table I shows the characteristics of the 2589 recruited infants, and Fig 1 shows the participant flow. Of 448 infants with a positive egg-induced SPT response, 340 (76%) underwent an OFC. In total, 231 infants were classified as having egg allergy (Fig 1).
Relationship between timing of introduction of egg and egg allergy
Infants introduced to egg at 4 to 6 months had a lower risk of egg allergy than those introduced to egg after that time (Table II
Discussion
This is the first large-scale epidemiologic study to examine relationships between timing of infant feeding milestones and subsequent risk of challenge-proven food allergy in an unselected population. Introducing cooked egg into the infant’s diet at 4 to 6 months of age was associated with a substantially lower risk of egg allergy than later introduction, even after controlling for family history of allergy and infant allergy symptoms. In contrast, any association between age at introduction of
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Supported by the Australian National Health & Medical Research Council, the Ilhan Food Allergy Foundation, and AnaphylaxiStop. K. J. A. is a Viertel Senior Medical Research Fellow, and L. C. G., M. W., M. C. M., A. J. L., A.-L. P., and S. C. D. hold National Health and Medical Research Council Awards. J. J. K., P. E. M., and T. D. are Australian Postgraduate Award scholars. T. T. is a recipient of a Malaysian Government Scholarship.
Disclosure of potential conflict of interest: N. J. Osborne and K. J. Allen have received research support from the Australian Egg Corporation Limited. M. Wake and L. C. Gurrin have received research support from the Australian National Health and Medical Research Council. M. L. K. Tang is on the Medical Advisory Board for Nestlé. S. C. Dharmage has received research support from the Clifford Craig Trust and the Sypkes Trust. The rest of the authors have declared that they have no conflict of interest.