| American Academy of Pediatrics (AAP) [12] |
2019 |
High-risk infants (presence of severe eczema and/or egg allergy) should be introduced to peanut as early as 4–6 months of age, following successful feeding of other solid food(s) to ensure the infant is developmentally ready. Allergy testing is strongly advised prior to peanut introduction for this group. Infants with mild-to-moderate eczema should be introduced to peanut around 6 months of age, in accordance with family preferences and cultural practices, to reduce the risk of peanut allergy Infants without eczema or food allergy who are not at increased risk: peanut should be introduced freely into the diet together with other solid foods and in accordance with family preferences and cultural practices.
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| Asia Pacific Association of Pediatric Allergy, Respirology & Immunology (APAPARI) [13] |
2017 |
Healthy infants: Introduce complementary foods at 6 months of age. At-risk infants (family history of atopy): No delay in introduction of allergenic foods. To be introduced in a sensible manner once weaning has commenced. High-risk infants with severe eczema: Allergy testing to egg (and peanut in countries with high peanut allergy prevalence). Supervised oral challenges in sensitized infants, followed by introduction of the allergenic food into the infant’s regular diet if challenge negative. Introduction of all allergenic foods should not be delayed. Aggressive control of eczema.
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| Australian Society of Clinical Immunology and Allergy (ASCIA) [14] |
2020 |
At around six months, but not before four months, start to introduce a variety of solid foods, starting with iron rich foods, while continuing breastfeeding. All infants should be given allergenic solid foods including peanut butter, cooked egg, dairy, and wheat products in the first year of life. This includes infants at high risk of allergy.
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| Canadian Paediatric Society (CPS) [15] |
2021 |
For high-risk infants, encourage the introduction of allergenic foods (e.g., cooked (not raw) egg, peanut) early, at about 6 months and not before 4 months of age, in a safe and developmentally appropriate way, at home. In infants at low risk for food allergy, allergenic foods can also be introduced at around 6 months of age. When allergenic foods have been introduced, make sure that ongoing ingestion of age-appropriate serving sizes is regular (i.e., a few times a week), to maintain tolerance.
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| European Academy of Allergy and Immunology (EAACI) [16] |
2020 |
The EAACI Task Force suggests introducing well-cooked hen’s egg, but not raw egg or uncooked pasteurized egg, into the infant diet as part of complementary feeding to prevent egg allergy in infants. In populations where there is a high prevalence of peanut allergy, the EAACI Task Force suggests introducing peanuts into the infant diet in an age-appropriate form as part of complementary feeding in order to prevent peanut allergy in infants and young children. The EAACI Task Force suggests avoiding supplementing with cow’s milk formula in breastfed infants in the first week of life to prevent cow’s milk allergy in infants and young children (low quality evidence).
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| German Society for Allergology and Clinical Immunology (DGAKI) [17] |
2014 |
The current recommendation in Germany to introduce solid foods to infants over the age of 4 months is reasonable given increasing nutritional requirements. The introduction of solid foods should not be delayed as a means of allergy prevention. There is no evidence to suggest that dietary restriction in the form of avoiding potent food allergens in the first year of life has a preventive effect. Such a measure is therefore not recommended. There is currently no reliable evidence that the introduction of potent food allergens during the first 4 months of life has a preventive effect. There is evidence that a child’s consumption of fish during the first year of life has a protective effect against the development of atopic diseases. Fish should be introduced in solid foods.
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| National Institute of Allergy and Infectious Diseases (NIAID) [18] |
2017 |
For infants with severe eczema, egg allergy, or both: Strongly consider evaluation by sIgE measurement and/or SPT and, if necessary, an OFC. Based on test results, introduce peanut-containing foods as early as 4 to 6 months of age to reduce the risk of peanut allergy. For infants with mild-to-moderate eczema: introduce age-appropriate peanut-containing food around 6 months of age. For infants without eczema or any food allergy: introduce age-appropriate peanut-containing foods freely together with other solid foods and in accordance with family preferences and cultural practices.
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