Systematic review of the relationship between early introduction of solid foods to infants and the development of allergic disease.
OBJECTIVE
To assess the evidence that early solid feeding (before age 4 months) increases the risk of allergic disease.


METHODS
MEDLINE, the Cochrane Library, and the Drugs and Pharmacology section of EMBASE with key words "infant," "food," and "allergy."


METHODS
We found 2719 article citations and reviewed references of relevant articles. We critically evaluated the methods and results of articles that met inclusion criteria. We identified 13 studies that met inclusion criteria. There was only 1 controlled trial.


METHODS
Allergic disease.


RESULTS
Five studies found a positive association between early solid feeding and eczema, with a persistence of the association for 10 years in 1 study. Four studies found no association. One study found an association between early solid feeding and pollen allergy. We found no strong evidence to support the association between early solid feeding and the development of persistent asthma, persistent food allergy, allergic rhinitis, or animal dander allergy.


CONCLUSIONS
Systematic review of available evidence suggests that early solid feeding may increase the risk of eczema. However, there are little data supporting an association between early solid feeding and other allergic conditions. Since many studies had problematic methods, additional controlled trials are needed to help guide physicians as they advise parents about the allergic risks of early introduction of solids.
Tarini
Beth A
BA
Robert Wood Johnson Clinical Scholars Program, Department of Pediatrics, University of Washington, Seattle 98195-7183, USA. btarini@u.washington.edu
Carroll
Aaron E
AE
Sox
Colin M
CM
Christakis
Dimitri A
DA
D004485:Eczema; D006801:Humans; D006969:Hypersensitivity, Immediate; D007223:Infant; D007225:Infant Food; D012135:Respiratory Sounds; D013997:Time Factors