Population response to change in infant feeding guidelines for allergy prevention - 30/01/14
, Rachel L. Peters, MPH b, c, Jennifer J. Koplin, PhD b, e, Mimi L.K. Tang, MBBS, PhD, FRACP, FRCPA, FAAAAI a, b, c, Lyle C. Gurrin, PhD b, e, Anne-Louise Ponsonby, MBBS, FAFPHM, FRACP, PhD b, c, Adrian J. Lowe, PhD b, e, Melissa Wake, MD, FRACP b, c, f, Shyamali C. Dharmage, MBBS, MSc, MD, PhD b, efor the
HealthNuts study investigators
Abstract |
Background |
It is unknown whether population infant feeding practices have changed since recently revised Australian allergy guidelines removed recommendations to delay allergenic solids.
Objectives |
We sought to determine whether updated 2008 guidelines were associated with changes in feeding practice and to determine whether sociodemographic factors influenced this response.
Methods |
In a population-based, cross-sectional study (HealthNuts) of 5276 infants recruited between 2007 and 2011 in Melbourne, Australia, parents reported on infant feeding practices. Multinomial logistic regression was used to investigate the associations between recruitment year and feeding practices and whether these associations were modified by sociodemographic factors.
Results |
Compared with participants recruited in 2007-2009, those recruited in 2009-2011 were more likely to introduce solids at age 4 months (adjusted multinomial odds ratio [aMOR], 1.21; 95% CI, 1.02-1.45; P = .032) and less likely to introduce solids at age 6 months (aMOR, 0.80; 95% CI, 0.69-0.92; P = .002), egg after 6 months (aMOR, 0.82; 95% CI, 0.71-0.94; P = .004), and peanut after 12 months (aMOR, 0.70; 95% CI, 0.49-0.98; P = .037). Although parents recruited in 2009-2011 were less likely to formula feed (aMOR, 0.84; 95% CI, 0.72-0.98; P = .023), formula-fed infants were more likely to be given a partially hydrolyzed formula (aMOR, 1.37; 95% CI, 1.12-1.70; P = .003). These changes were significantly stronger among families with a higher socioeconomic status and those without a family history of allergies.
Conclusion |
Updated national allergy guidelines are associated with reduced delay in introduction of solids, egg, and peanut and an increase in partially hydrolyzed formula use among formula-fed infants. Higher socioeconomic status and absence of family history of allergies were associated with better uptake of feeding guidelines.
Le texte complet de cet article est disponible en PDF.Key words : Food allergy, infant feeding, solids, egg, peanut, formula, weaning, family history, guidelines
Abbreviations used : aMOR, MOR
Plan
| Supported by funding from the National Health & Medical Research Council (NHMRC) of Australia, the Ilhan Food Allergy Foundation, AnaphylaxiStop, the Charles and Sylvia Viertel Medical Research Foundation, and the Victorian Government's Operational Infrastructure Support Program. K.J.A. is a Viertel Senior Medical Research Fellow. J.J.K., M.W., A.J.L., and S.C.D. are supported by the NHMRC. R.L.P. is an Australian Postgraduate Award PhD scholar. ALK-Abelló S.A., Madrid, Spain, supplied the skin prick testing reagents. |
|
| Disclosure of potential conflict of interest: D. Tey has received payment for lectures from Abbott and Schering-Plough. K. J. Allen is a board member for the Ilhan Food Allergy Foundation and has received payment for lectures from Nutricia, Alphafarm, and Pfizer. M. L. K. Tang is a member of the medical advisory boards for the Nestlé Nutrition Institute and Nutricia, has received payment for lectures from Nutricia, and received payment from the Australian government as part of the National Health and Medical Research Council Breastfeeding and Infant Feeding Workshop. A.-L. Ponsonby has received a grant from the National Health and Medical Research Council, has consultant arrangements with Financial Markets for Children, and is employed by the Murdoch Children's Research Institute. A. J. Lowe has received research support from the Australian National Health & Medical Research Council. M. Wake has received research support from the Australian National Health & Medical Research Council and has consultant arrangements with Wollongong University and the Australian Department of Social Services. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 133 - N° 2
P. 476-484 - février 2014 Retour au numéro
Article précédent
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- Rachel L. Peters, Shyamali C. Dharmage, Lyle C. Gurrin, Jennifer J. Koplin, Anne-Louise Ponsonby, Adrian J. Lowe, Mimi L.K. Tang, Dean Tey, Marnie Robinson, David Hill, Helen Czech, Leone Thiele, Nicholas J. Osborne, Katrina J. Allen, HealthNuts study
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