Can eating certain foods early reduce the risk of children getting allergies later?
This article summarises some of the findings from the research papers: EAT (Enquiring About Tolerance) study conducted by Michael Perkin, Kirsty Logan & Gideon Lack, June 2015 and the follow up study Early Gluten Introduction and Celiac Disease in the EAT Study A Prespecified Analysis of the EAT Randomized Clinical Trial, September 2020.
It is in no way meant to constitute medical advice and should not be interpreted as Lauren Brown or Busy Brains Activity Packs endorsing early weaning or the unsupervised introduction of allergenic foods. Seek professional advice if you have any questions or concerns regarding your baby, possible allergies or weaning. What I do aim to do is present you with the details of this study, along with the later follow up which looked at gluten, in an unbiased, informed way so you may be armed with the knowledge I didn’t have when I was weaning my children.
I can remember quite vividly the feeling of fear I had when I gave my eldest child peanuts for the first time. There are no allergies in my family, but it was the one type of food that I knew from my experiences as a teacher that some children could have a pretty spectacular reaction to and I was nervous. I remember waiting until my husband got home from work before I fed her just in case she had a severe reaction. Perhaps I was over-cautious but, at the time, I remember it worried me.
With this in mind, I wasn’t overly surprised with what I’ve just read in the EAT research paper. It says that in the UK, ‘only 8% of infants had been given peanuts or peanut products’ by 8-10 months of age. What was interesting though was the researchers’ observation that this delay has coincided with an increase in the number of infants appearing to suffer from food allergies.
It made me think back to something that happened when my son was a baby. He had suffered from severe eczema since birth and had been referred to the hospital for allergy testing.
To be honest, I didn’t really expect the tests to show up any food allergies except perhaps a milk allergy, but having already tried countless creams and potions for his skin I was happy to try to find a cause for his eczema.
He was about 8 months old and I remember feeling fairly happy with his weaning journey at the time. I’d been introducing new foods to him steadily since he was 6 months old.
Having already weaned my daughter, I felt more confident this time around. I followed a similar pattern of foodstuffs and, as far as I was concerned, was introducing new foods as was advised, one new item every few days.
You can probably imagine my horror when, during the assessment, the doctor asked me if I’d ever given him nuts.
I hadn’t at that stage, we’d done various vegetables, fruits, meat, fish and egg but I had not yet reached nuts. What followed was the statement “children with eczema are much more likely to develop food allergies. As you’ve not given him nuts yet this may mean it’s already too late and he may now have a reaction.”
I’m sure you can imagine my devastation and worry. At the time I did not know that I should have introduced these foods earlier or that he was any more at risk than anyone else! If I had known of course I would have given them to him sooner. I was horrified that I could have unwittingly caused a problem.
In hindsight, I know now that the doctor in question was very likely talking about the findings of the EAT study. It would have been newly published at the time of my appointment. One of the results described in the paper was that giving 2g of peanuts per week from 3 months of age ‘almost completely prevented peanut allergy’. This is an extraordinary claim and one I would please ask you to treat with caution. I am not suggesting you give your baby peanuts from 3 months old, please seek personal professional advice before doing so. The babies in the study were first tested for allergy and were closely monitored by professionals.
To be clear, current advice from the World Health Organization states that babies should be exclusively breastfed for the first six months at which point ‘nutritious complementary foods’ can be introduced alongside continued breastfeeding. The UK Government also suggest mothers should wait until ‘around’ six months. They also advise parents to avoid those that may cause allergies including: ‘wheat-based foods...eggs, fish, shellfish, nuts (and) seeds’ prior to six months. The 2015 EAT study, however, aimed to question this, saying that there is very little evidence to suggest that introducing these foods later does anything to reduce allergic disease. In fact, the authors, like my doctor, said there is ‘now observational evidence that early introduction of cows’ milk, egg or peanut during infancy may prevent the development of food allergies.’ The study involved 1303 babies (aged between 13 and 17 weeks) who had been recruited from across the UK to represent the general population and aimed to find out whether giving babies certain foods earlier would mean they were less likely to develop allergies. The babies were randomly assigned to one of two groups. Parents of one group were told to follow normal government guidelines for weaning (exclusive breastfeeding until 6 months followed by the introduction of solid foods around six months). While the other babies (Group 2 – Early introduction group (EIG)) were given a feeding schedule which introduced their babies to six foods that are known to cause reactions in some children: cows’ milk, peanut, cooked (boiled) hen’s egg, wheat, sesame and fish (cod). All the mothers were instructed to continue breastfeeding alongside solid foods regardless of whether they were in group 1 or 2. The results did suggest that the children in Group 2 (the early intervention group) were less prone to food allergies than the children in Group 1. However, many of these findings were ‘not statistically significant’, which means the researchers couldn’t rule out the possibility that the findings were due to chance.
One striking result which was statistically significant was that the babies in the Early Intervention Group showed less sensitivity to wheat at both 12 and 36 months than the children in group 1.
These findings prompted a second research project looking specifically at Early Gluten Introduction and Celiac Disease. Celiac Disease is thought to affect around 1% of children and adults and is caused by a reaction triggered by gluten that is found in wheat, barley, rye, and sometimes oats. It can cause symptoms such as diarrhoea, bloating and vomiting.
The second study involved 1004 infants.
They were again split into two groups, 516 were asked to follow Government guidelines.
As before, the parents of the other 488 babies were asked to consume 6 allergenic foods (peanut, sesame, hen's egg, cow's milk, codfish, and wheat) in addition to breast milk, but this time from 4 months old. As part of this, the Early Intervention Group were required to consume two Weetabix biscuits a week, equivalent to 4g of wheat protein. The results were analysed to look at the incidence of celiac disease amongst the two groups. The study showed that none of the children who had been given Weetabix went on to suffer from celiac disease, whereas 7 of children who were weaned traditionally were later diagnosed with the condition. This was a ‘really exciting’ finding according to researcher Dr Kelly Logan and seemed to suggest that their theory might be correct. However, it is really important to remember that the study was small and needs to be repeated on a much larger scale before any firm conclusions can be made.
The Assistant Professor in Medical Statistics, Dr Baptiste Leurent, has reiterated this by saying that the sample is so small, the findings "could have happened by chance alone". He went on to say "Other studies have found an effect toward the other direction, and is it is therefore too early to suggest any change in the baby's diet to the public."
I think both studies are really fascinating and provide exciting avenues to explore in the future. But again, I would please stress, these babies were monitored by professionals and were tested for severe allergies before the experiment began.
With this in mind, would I have done anything differently had I known about this survey when I was weaning my son? Probably not! But I wouldn’t have wasted energy on feeling guilty when that doctor shamed me into thinking I’d made a mistake!
I aim to share my experiences of motherhood to make things a little bit easier for others. If you would like to follow me on my journey you can find me on Instagram.com/busybrainsactivitypacks and www.facebook.com/busybrainsactivitypacks