PEANUT * TREE NUTS * SOY * EGG
MILK * WHEAT * FISH * SEAFOOD
"An entertaining and provocative book that explores the evidence behind infant feeding advice. Clearly, it is time for pediatricians to recommend that infants 'Eat the Eight!'"
Carolyn Sax, MD, Assistant Clinical Professor of Pediatrics,
Harvard Medical School
The "Big Eight" foods are responsible for 90% of food allergy reactions. I have been practicing Pediatrics for over 30 years during which the prevalence of food allergy has grown enormously. Learn here about the important recent medical findings that have shown that feeding these foods to infants "early and often" can reduce their risk of developing food allergy. Ron Sunog, MD
So are foods containing milk, egg, fish, shellfish, tree nuts, wheat, and soy.
Most parents believe that they should delay introducing these foods to infants because that's what was recommended starting around 1990. This recommendation was made with the hope that fewer infants would develop food allergy, but there was no medical evidence for this approach and the prevalence of food allergy actually grew enormously. By 2008 experts agreed that these foods were safe for infants.
Then, in 2015 the landmark LEAP study, published in the New England Journal of Medicine, showed that feeding peanut puffs to high-risk infants significantly reduced their risk of developing peanut allergy. That's right--eating peanut food during infancy prevents peanut allergy! Other studies have shown that early feeding of wheat, egg, and milk may also be beneficial.
In January 2017 the National Institute of Health (NIH) established guidelines for introducing peanut to infants, yet over a year later, few Pediatricians inform parents of these guidelines and few parents are aware of them. Even among those who have heard this news, many remain convinced that they should delay introduction of peanut and the Big Eight. Perhaps it's true that "It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so" (attributed to Mark Twain). And parents continue to "know for sure" that delayed introduction of certain foods is the correct approach.
It is the goal of Eat The Eight, to spread the word that introducing these foods to infants is safe and can reduce their risk of becoming allergic. Go to the Library below to find the National Institute of Health Guidelines and much more. Be sure to discuss this information with your Pediatric Provider. And I'd love to hear your thoughts and ideas about infant feeding and allergy. How do you think we can best teach parents about this and make them comfortable with it?
"Complementary foods, including potential allergens, are not restricted after 4-6 months of age (not applicable for infants experiencing allergic reactions)."
(Guidelines, from the AAP and the American Academy of Allergy, Asthma and Immunology, 2010.)
"...several studies have shown that introduction of foods like eggs, fish, milk and nuts during the first 12 months of life actually reduces a child's risk of developing food allergy." (Dr. Carolyn Sax, Boston Children's Hospital Pediatric Health Blog, March 2014.)
"...introduce solid foods into your baby's diet..between 4 and 6 months..there is no reason to wait until a baby is older before introducing highly allergenic foods, and some studies suggest that it may even be helpful to introduce these foods early." (Dr. Todd Green, Kids With Food Allergies website, April 2014.)
"My clinical approach has long favored early peanut introduction..." (Dr. George Du Toit, Learning Early About Peanut Allergy investigator, NEJM online forum, March 2015.)
"...early feeding was not associated with increased risk of food allergy, so parents should have no concern about introducing allergenic foods in their non-food allergic children's diets. Parents should consult with their Pediatrician if they have questions about the timing of introducing allergenic foods." (Dr. James Baker, CEO at Food Allergy Research and Education, March 2016, prweb.com.)
"...early introduction of allergenic foods (egg, cow's milk products, and peanut) before age one should be encouraged and is better than food avoidance for reducing the risk of food sensitization." (Maxwell Tran, The Effects Of Infant Feeding Practices On Food Sensitization In A Canadian Birth Cohort, the American Thoracic Society, May, 2016.)
(The experts and organizations quoted above and elsewhere are neither affiliated with nor sponsors of Eat The Eight.)
NIH Guidelines, Introducing Peanut to Infants
The landmark New England Journal of Medicine study on peanut allergy
American Academy of Allergy, Asthma, and Immunology (AAAAI) on peanut allergy prevention
Food Allergy Research and Education (FARE) on peanut allergy studies
American Academy of Pediatrics (AAP) Guidelines For prevention of Food Allergy (Published 2010!)
National Institute of Health (NIH), Peanut Allergy Prevention Strategy is Nutritionally Safe
Report of the Canadian Healthy Infant Longitudinal Development (CHILD) Study, presented at the meeting of the American Thoracic Society May 2016
Delaying initial exposure to cereal grains until after 6 months may increase the risk of developing wheat allergy. (Published in Pediatrics 2006!)
Introducing solid foods while continuing to breast feed could prevent child allergies
Timing of initial exposure to cereal grains and the risk of wheat allergy.
Review of Meta-Analysis supportive of early introduction of peanut and egg, Journal of the American Medical Association, Sept. 2016
I am a Pediatrician still doing annual physicals, treating ear infections, and guiding parents after more than 30 years.
Why start Eat The Eight?
Because the growing number of children with peanut allergy is at least partly due to the very wrong medical advice that Pediatricians have been giving parents since around 1990 and I want to help fix that.
Because around 2.5% of children are now peanut allergic.
Because 4,000,000 infants will be born this year and around 100,000 of them will develop peanut allergy if we don't get the right information to parents. (If we do, that number may be decreased by over 80%!)
Because a recent study showed that fully 3 years after the LEAP study and over a year after the NIH guidelines only 11% of Pediatricians are informing parents about these guidelines and the benefits of early peanut introduction.
Because I have a long-standing interest in nutrition.
Because I love peanut butter.
So, I will continue to post new information that I hope informs and helps. And I'm asking you to post your comments. What do you think about feeding the eight to your infant? What worries you and why? What can we--Pediatricians and other Pediatric Providers--do to help get the message across and make parents comfortable. I hope to hear from you.
As a Pediatrician with over 30 years of experience, I have had the pleasure and honor of guiding thousands of families as they begin feeding their infants. With recent studies showing that early introduction can prevent allergy, I have been informing families that it is best to feed their infants a wide variety of nutritious foods, including foods containing peanut (in safe-to-eat form to avoid the choking risk of peanuts for infants). To make introducing peanuts to infants nutritious, safe, and convenient, I worked with Puffworks to develop Puffworks baby, combining superior nutrition and peanut protein in a delicious puff just right for infants.
Ron Sunog, MD
Founder of EatTheEight.com
Medical Advisor to Puffworks
Dr. Ron Sunog grew up in New York, earned his MD at Boston University's accelerated six-year medical program, and completed his Residency and Chief Residency in Pediatrics at Boston City Hospital. He lives near Boston with his family and has been taking care of infants and children of all ages in Pediatric Practice for over thirty years. Having long had a special interest in nutrition, he was inspired by the LEAP study to create EatTheEight to inform parents about infant feeding to reduce the risk of developing food allergy. In 2017 he joined Puffworks as Medical Advisor to help create Puffworks baby, a better way to introduce peanut to infants to help reduce the risk of developing peanut allergy .
(Above title from the New York Times article, by Roni Caryn Rabin, 1/5/2017.)