FOOD ALLERGY PREVENTION

Food allergy has significant individual, household and societal costs with the increasing prevalence of allergic disease becoming a public health concern, particularly in westernised, urbanised countries. Consequently there is great interest in the aetiology of food allergy in general, and the primary prevention of food allergy in particular. The infant's immune system first comes into contact with food allergens as a fetus, continues being exposed after birth via breast milk, and again when solids are introduced into the diet. It is unclear which, if not all, of these exposure time points are important in food allergy development; so food allergy prevention strategies tend to focus on pregnancy and the first year of life. Recommendations around food allergy prevention strategies have changed greatly in the last decade from some quite detailed prescriptive recommendations to fewer more evidence-focused recommendations and a call for more research into the field. This paper discusses the current evidence base within a historical perspective and then outlines the recommendations we can currently make to our patients from the available evidence.