Food allergy and the introduction of solid foods to infants: a consensus document. Adverse Reactions to Foods Committee, American College of Allergy, Asthma and Immunology.
OBJECTIVE
To make recommendations based on a critical review of the evidence for the timing of the introduction of solid foods and its possible role in the development of food allergy.


METHODS
MEDLINE searches using the following search algorithm: [weaning AND infant AND allergy]/[food allergy AND sensitization]/[dietary prevention AND food allergy OR allergens]/[Jan 1980-Feb 2006].


METHODS
Using the authors' clinical experience and research expertise, 52 studies were retrieved that satisfied the following conditions: English language, journal impact factor above 1 or scientific society, expert, or institutional publication, and appraisable using the World Health Organization categories of evidence.


RESULTS
Available information suggests that early introduction can increase the risk of food allergy, that avoidance of solids can prevent the development of specific food allergies, that some foods are more allergenic than others, and that some food allergies are more persistent than others.


CONCLUSIONS
Pediatricians and allergists should cautiously individualize the introduction of solids into the infants' diet. With assessed risk of allergy, the optimal age for the introduction of selected supplemental foods should be 6 months, dairy products 12 months, hen's egg 24 months, and peanut, tree nuts, fish, and seafood at least 36 months. For all infants, complementary feeding can be introduced from the sixth month, and egg, peanut, tree nuts, fish, and seafood introduction require caution. Foods should be introduced one at a time in small amounts. Mixed foods containing various food allergens should not be given unless tolerance to every ingredient has been assessed.
Fiocchi
Alessandro
A
American College of Allergy, Asthma and Immunology, Melloni Paediatria, University of Milan Medical School, Melloni Hospital, Milan, Italy. allerg@tin.it
Assa'ad
Amal
A
Bahna
Sami
S
D000367:Age Factors; D000485:Allergens / Q000009:adverse effects; D000818:Animals; D010367:Arachis / Q000009:adverse effects; D001942:Breast Feeding; D002417:Cattle; D002645:Chickens; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003611:Dairy Products / Q000009:adverse effects; D002523:Edible Grain / Q000009:adverse effects; D004531:Eggs / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005512:Food Hypersensitivity / Q000209:etiology / Q000517:prevention & control*; D005638:Fruit / Q000009:adverse effects; D017408:Guidelines as Topic; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000009:adverse effects; D007231:Infant, Newborn; D008460:Meat / Q000009:adverse effects; D016269:Milk Hypersensitivity / Q000209:etiology / Q000517:prevention & control; D009754:Nuts / Q000009:adverse effects; D017747:Seafood / Q000009:adverse effects; D014675:Vegetables / Q000009:adverse effects; D014886:Weaning; D014944:World Health Organization
D000485:Allergens