Age at introduction to complementary solid food and food allergy and sensitization: a systematic review and meta-analysis
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Published version
Author(s)
Type
Journal Article
Abstract
BACKGROUND AND OBJECTIVE: An infant's age at introduction of complementary solids may contribute to food allergy. We aimed to synthesize the literature on the association between age at introduction of complementary solids, excluding milk products, and food allergy and sensitization. DESIGN: We searched the electronic databases PubMed and EMBASE (January 1946-February 2017) using solid food, allergy and sensitization terms. METHODS: Two authors selected papers according to inclusion criteria, identifying 16 cohort studies, 1 case-control study and 8 randomized controlled trials (RCTs). Pooled effects across studies were estimated using random-effects meta-analysis. RESULTS: Cohort studies - Introducing complementary solids at age ≥4 months versus <4 months was not associated with food allergy (OR 1.22; 95%CI, 0.76-1.96) but was associated with food sensitization (OR 1.93; 95%CI 1.57-2.38). First exposure from age 4-6 months versus <4 months was not associated with food allergy (OR 1.01; 95%CI, 0.64-1.60) but was associated with food sensitization (OR 2.46; 95%CI 1.55-3.86). RCTs - Egg exposure from age 4 months was associated with reduced egg allergy (OR 0.63, 95%CI, 0.44-0.90) and sensitization (OR 0.76, 95%CI, 0.51-0.95). Peanut exposure from age 4 months compared to delayed exposure was associated with reduced peanut allergy (OR 0.28, 95%CI 0.14-0.57). CONCLUSIONS: We found no evidence from observational studies that introducing solids before 4 months protected against food allergy, but there was evidence for protection against food sensitization. From RCTs, introducing egg from 4-6 months and peanut from 4-11 months, reduced the risk of egg allergy, peanut allergy and egg sensitization. This article is protected by copyright. All rights reserved.
Date Issued
2019-06-01
Date Acceptance
2019-03-01
Citation
Clinical and Experimental Allergy, 2019, 49 (6), pp.754-769
ISSN
0954-7894
Publisher
Wiley
Start Page
754
End Page
769
Journal / Book Title
Clinical and Experimental Allergy
Volume
49
Issue
6
Copyright Statement
© 2019 Wiley. This is the accepted version of the following article: Burgess, J. A., Dharmage, S. C., Allen, K. , Koplin, J. , Garcia‐Larsen, V. , Boyle, R. , Waidyatillake, N. and Lodge, C. J. (2019), Age at introduction to complementary solid food and food allergy and sensitization: a systematic review and meta‐analysis. Clin Exp Allergy. Accepted Author Manuscript., which has been published in final form at https://dx.doi.org/10.1111/cea.13383
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30861244
Subjects
Science & Technology
Life Sciences & Biomedicine
Allergy
Immunology
INFANT-FEEDING PRACTICES
HIGH-RISK INFANTS
ATOPIC SENSITIZATION
BIRTH COHORT
EGG ALLERGY
1ST YEAR
ECZEMA
LIFE
GUIDELINES
CHILDREN
Allergy
1107 Immunology
1117 Public Health and Health Services
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2019-03-12