Introduction to Allergenic Solids


There is new evidence showing that early introduction of non-choking peanuts to infants at high risk of developing peanut allergy is safe and led to an 81% reduction in the subsequent development of a peanut allergy(1). In January 2017, new clinical guidelines to address prevention of peanut allergy were released(2) and current recommendations from the Canadian Pediatric Society are to introduce all allergenic solids to children at risk of food allergy at around 6 months of age but not before 4 months of age.
It is important that parents feel comfortable with this new information and confident enough to introduce allergenic solids to their children at home during infancy to prevent the development of food allergies. Parents may have questions and concerns regarding the risk of severe allergic reactions to foods. Therefore, it is essential that healthcare providers feel both confident and competent in applying this new information on introduction of allergenic solids into their practice.

​​Feeding infant


To support implementation of the new guidelines, pediatric allergists from BC Children’s Hospital partnered with public health practitioners in Vancouver on a quality improvement initiative titled ‘Prevention of Peanut Allergy Pilot’ to support knowledge translation. This 2017 project addressed peanut specifically, as emerging evidence initially focused on this particular food. 

The goals of this initiative were two-fold: 

1) To increase the confidence and competence of public health providers in supporting parents with concerns about introducing non-choking peanuts as part of introduction to solids. 

2) To increase the confidence and competence of parents to offer non-choking peanuts in their homes as they introduce solids to their infants. 

Confidence in counselling parents about introducing non-choking peanuts increased among healthcare providers after receiving education from the pediatric allergists about the new guidelines.(3) There was a significant positive change in confidence among parents to introducing non-choking peanuts in their home. This confidence was sustained three months after receiving information about the new guidelines.

Peanut allergy young female


We now know that early introduction of common allergenic solids can help to prevent food allergy in infants with increased risk. Results from the ‘Prevention of Peanut Allergy Pilot’ demonstrated that health care provider education and support increased parent confidence with early introduction of allergenic solids. These results informed the development of an interactive online learning module for healthcare providers, to facilitate more widespread dissemination of this information to parents. 

With funding from the BC Centre for Disease Control (BCCDC), and in partnership with BC Children’s Hospital, the Ministry of Health, primary care providers and the University of British Columbia’s Continuing Professional Development team, Child Health BC created an on-line course designed to:

1) help healthcare providers better understand the development of food allergies

2) provide tools and resources to support families with the introduction of allergenic solids

Click here to access: Preventing Food Allergies in Infants: Early Introduction to Allergenic Solids

Target audience: family physicians, nurse practitioners, pediatricians, pharmacists and other health care providers that care for children.

Up to 1.0 Mainpro+/MOC Section 3

1.   Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, et al. Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy. N Engl J Med. 2015;372(9):803–13. 
2.   Togias A, Cooper SF, Acebal ML, Assa’ad A, Baker JR, Beck LA, et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases–sponsored expert panel. World Allergy Organ J. 2017 Jan 6;10(1):1. 
3.   Lee NJ, Soller L, McConnell-Nzunga J, Scarr J, Chan ES, Crocker B, et al. Impact of Allergist-Facilitated Education on Public Healthcare Provider Confidence in Counseling about Early Peanut Introduction. J Allergy Clin Immunol. 2019 Feb 1;143(2):AB71.