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Timing of Introduction, Sensitization, and Allergy to Highly Allergenic Foods at Age 3 Years in a General-Population Canadian Cohort

Published:October 30, 2019DOI:https://doi.org/10.1016/j.jaip.2019.09.039

      Background

      Early dietary introduction of highly allergenic foods has been associated with decreased risk of food allergy in high-risk infants.

      Objective

      Early introduction of highly allergenic foods for lower risk infants was examined using Canadian Healthy Infant Longitudinal Development (CHILD) Study data.

      Methods

      CHILD participants were recruited from the general population before birth. Every 6 months, caregivers reported food introduction and allergic reactions. At ages 1 and 3 years, sensitization to peanut, egg, and cow's milk was measured by skin prick testing (SPT) and atopic dermatitis diagnosed at clinical visits. Multivariable logistic regression was used to examine associations between timing of introduction to peanut, egg, and cow's milk and the presence at 3 years of sensitization (positive SPT) and probable clinical IgE-mediated allergy (sensitization with no current consumption and convincing history of allergic reaction to the specific food).

      Results

      Among 2669 CHILD participants at age 3 years, 101 (3.80%) showed sensitization to peanut, 59 (2.21%) to egg, and 30 (1.12%) to cow's milk; 46 (1.78%) showed probable clinical IgE-mediated allergy to peanut, 4 (0.16%) to egg, and 2 (0.08%) to cow's milk. Infants introduced to peanut after 12 months had increased odds of sensitization (odds ratio [OR]: 2.38, 95% confidence interval [CI]: 1.39-4.07) and probable clinical allergy (OR: 4.04, 95% CI: 1.66-9.85) to peanut at 3 years. Associations persisted after exclusion of high-risk infants with moderate-to-severe atopic dermatitis in the first year/egg sensitization at 1 year.

      Conclusions

      General-population infants introduced to peanut after age 12 months were more likely to have sensitization and probable clinical allergy to peanut at 3 years.

      Key words

      Abbreviations used:

      CHILD Study (Canadian Healthy Infant Longitudinal Development Study), CI (Confidence interval), LEAP (Learning Early about Peanut), OR (Odds ratio), PAF (Population attributable fraction), SPT (Skin prick testing)
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