Food allergen introduction practices and parent/caregiver attitudes based on family history of food allergy.

Background: The National Institute of Allergy and Infectious Disease (NIAID) addendum guidelines for primary prevention of peanut allergy1 provide recommendations regarding peanut introduction, and a recent consensus statement highlighted the importance of timely introduction of other commonly allergenic solids, and the role of family history as a risk factor.2ObjectiveTo determine whether children in households with a food allergic parent/caregiver or sibling have different rates of being fed commonly allergenic solids during the first year of life than children lacking this family history.

Methods: A pretested survey was administered between January-February 2021 to a U.S. sample of 3,062 parents/caregivers of children born since the NIAID Addendum guidelines. Survey-weighted chi-square statistics and logistic regression models tested the independence of key variables across strata of interest before and after covariate adjustment.

Results: Peanut, almond, shellfish, and other tree nuts are more likely to be introduced to children with one or more food-allergic caregivers. Respondents with food-allergic parents (39.3%) and siblings with FA (35.8%) were more familiar with the 2017 NIAID guidelines compared to parents (12.9%) and siblings without FA (12.7%).

Conclusion: Findings suggest that respondents with food-allergic parents and siblings are more likely to have many of the most prevalent allergens introduced at younger ages, which could be due to knowledge related to the NIAID-sponsored guidelines and other national guidance, but that even among these higher-risk families overall rates of "early" introduction during infancy still remain relatively low.