A joint statement assessing the health benefits and risks of the introduction of peanut and hen’s egg into the infant diet before six months of age in the UK.
The Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) have published a joint statement outlining the assessment undertaken by the joint SACN-COT working group on the timing of introduction of peanut and hen’s egg into the infant diet before 6 months of age in the UK. This paper summarises the findings of the working group and provides consensus advice to government.
The benefit-risk assessment indicated that there were insufficient data to support the existence of a “window of opportunity” for the introduction of peanut before six months of age. Evidence that the introduction of hen’s egg before six months might be beneficial was limited and derived from RCTs where participants were not representative of the general population.
The benefit-risk assessment indicated that there were insufficient data to demonstrate that the introduction of peanut or hen’s egg into the infant diet between four and six months of age reduced the risk of developing food allergy to any greater extent than introduction from around six months.
Reasonable data exist to demonstrate that the deliberate exclusion or delayed introduction of peanut or hen’s egg beyond six to twelve months of age may increase the risk of allergy to the same foods.
Recommendations for government
The government should continue to recommend exclusive breastfeeding for around the first six months of life. Advice on complementary feeding should state that foods containing peanut and hen’s egg need not be differentiated from other complementary foods. Complementary foods should be introduced in an age-appropriate form from around six months of age, alongside continued breastfeeding, at a time and in a manner to suit both the family and individual child.
The deliberate exclusion of peanut or hen’s egg beyond six to twelve months of age may increase the risk of allergy to the same foods. Once introduced, and where tolerated, these foods should be part of the infant’s usual diet, to suit both the individual child and family. If initial exposure is not continued as part of the infant’s usual diet, then this may increase the risk of sensitisation and subsequent food allergy.
Families of infants with a history of early-onset eczema or suspected food allergy may wish to seek medical advice before introducing these foods.