Did dated recommendations contribute to spike of food allergies in kids?

TORONTO – Of all the advice pediatricians have had to dole out to parents, it’s food-related recommendations that have changed the most during Dr. Carl Cummings’ 30-year tenure.

Some doctors told patients to start introducing certain foods to their babies as early as one year old. For others, they suggested kids shouldn’t be eating peanuts, eggs or shellfish until they’re four.

This advice was all handed out in the name of hoping to keep allergies at bay in children. Meanwhile, organizations suggest food allergies have doubled between 1997 and 2011.

On Monday, the Canadian Paediatric Society (CPS) offered its own statement, suggesting that babies who are at high risk of developing a food allergy can be exposed to potential allergens as early as six months old.

READ MORE: Groups say babies may eat allergy-sparking foods as early as 6 months

“All of that [previous] information is really based on the consensus of experts,” Cummings explained to Global News. He’s a Montreal-based pediatrician, professor at the Montreal Children’s Hospital and co-author of the CPS statement.
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He’s referring to guidelines dating back to 2008 by the American Academy of Pediatrics, among other organizations. It cobbled together the best of expert opinion for its guidelines.

Now, he says the CPS statement is based on research – and there have been dozens of studies in the past few years – all pointing to parents introducing certain foods at the six-month mark. That’s quite the variation from the prior recommendations.

“[The old advice] was based on the consensus of opinion rather than actual evidence. The bottom line is it’s believed that the unnecessary delay probably contributed to some of the increase of food allergies that we see,” Cummings told Global News.

Read the full CPS statement here.

There are eight foods that account for 90 per cent of all reactions: milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish, according Food Allergy Research and Education.

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Watch: Dr. Doug Campbell from St. Michael’s Hospital explains the new CPS guidelines

READ MORE: Food allergies nearly twice as common among well-educated: study

The old recommendations were based on the notion that introducing these foods later on in life would give children more time to strengthen their gut and mature their intestines. Cummings suggests that at the time, pediatricians thought that in infants, certain food particles could make their way through the intestine wall and into the blood stream sparking an allergic reaction.

Now, the CPS says that six months old is fair game. Delaying dietary exposure to peanuts, fish or eggs won’t reduce risk of developing a food allergy. And once these new foods are introduced, parents should keep offering them to their kids to build on tolerance.

Babies are considered at high risk of developing a food allergy if they have a parent or sibling with an allergic condition, food allergy or asthma.

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The old guidelines were meant specifically for high-risk kids, but it caught fire with other parents, according to Dr. Adelle Atkinson, a pediatric allergist at Sick Kids Hospital.

READ MORE: City kids more likely to have food allergies: study

But she warns that experts can’t say for certain if previous guidelines sparked the food allergies increase Canada has witnessed in recent years.

“We now know intuitively that there’s a window of tolerance,” she said. How much time parents have and how much food should be given needs to be closer examined,” she said.

“In very rough terms, the immune system matures for a period of time in infancy. As it’s maturing, allow it to be exposed so it’ll learn to tolerate [these allergy-inducing foods] and mature with that exposure and interaction,” she said.

Before this CPS statement was introduced, she was already telling her patients to feed their children eggs, peanuts and other foods.

Right now, about seven per cent of Canadians have food allergies. Other research suggests that food allergy in babies is on the rise, affecting more than 10 per cent of one-year-olds.

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The number of people who have a food allergy in general is on the rise, but there’s no clear-cut answer as to why.

The CPS also provided more recommendations. Take a look at the full list here.

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