In a nutshell: Tackling childhood allergies
Having a child with a food allergy is a daily struggle most parents would do anything to avoid. But with a doubling in the prevalence of severe food allergies over the past decade, it's clear avoidance just isn't working.
In the past, parents have been advised that to stop young children developing food allergies, they should prevent them eating foods that commonly cause them, such as dairy products, eggs, nuts and fish.
But the thinking about allergy prevention is changing, and some eminent allergists now believe the key to children avoiding allergies is for them to regularly eat foods containing allergens from infancy.
It's an approach that research has proved works. The Learning Early About Peanut allergy (LEAP) study compared children aged under one who consumed peanut with those who avoided it completely, and it showed peanut consumption reduced prevalence of peanut allergy by 80%.
Yet many parents are frightened to do it, particularly if they have food allergies themselves and believe their children are also at risk of developing them.
'The main problem is that we were given the wrong advice on how to prevent allergies'
But one mum Robin Nixon Pompa, whose own young child developed a life-threatening allergy to eggs and nuts, has written a book, Allergy-Free Kids, explaining the approach and the science behind it, and how she believes it halted and may even have helped 'cure' her infant daughter's food allergies, as well as stopping such allergies developing in her two younger children.
"The main problem is that we were given the wrong advice on how to prevent allergies," she says.
"Instead of avoiding it, we need to give our babies and children allergenic food early, carefully and often."
And while this can be a daunting prospect, particularly for allergic parents whose child is at high-risk of allergies, Robin reassures: "Allergic reactions are very scary, but fortunately researchers have found that in the early months, children are very unlikely to have a life-threatening reaction. There may be a few hives or some swelling, but you're not going to need to rush them to hospital.
"The logic used to be, let's wait for the immune system to be mature enough, or for the child to be old enough to express discomfort, before introducing potentially troublemaking allergens.
"But now studies suggest that for most babies, allergens are safe. And avoiding them may make food allergies more likely."
TRAINING THE IMMUNE SYSTEM
The idea behind the allergen consumption approach is that by introducing tiny amounts of an allergen into a child's diet and increasing the amount gradually, the child's immune system is educated to recognise allergens that it might wrongly have treated as a poison, and learn not to react to them.
Robin stresses, however, that care should be taken with the approach, particularly if a baby has a family history of food allergies or other signs that such allergies may already be present, or has eczema or dry skin. In such cases a child should be tested for allergies before being introduced to food allergens.
While introducing food allergens early in life can help prevent allergies from developing, overcoming existing allergies can still be "very tricky", she says, and desensitisation should be overseen by a medical professional and might not work.
"In other words, we don't have all the answers yet," she admits. "This is about preventing allergies, not curing them."
IN A NUTSHELL
Robin's nine allergy-avoidance tips...
1. During pregnancy and breastfeeding, there's no need to avoid allergenic foods.
2. The immune system may have a 'critical window' within which it can be most easily taught that all foods are safe.
3. This critical window is best seized from three to five months old and through toddlerhood.
4. To have a possible protective effect, allergens need to be given both early and often; intermittent exposure isn't enough.
5. From four months old, babies and young children should aim to eat at least two grams of each allergen protein a week.
6. Find ways to make allergens palatable.
7. Keep a feeding diary.
8. Aim to protect your baby from all food allergies, even if there's only one type in your family history.
9. Some children will develop food allergies no matter how well protected.