Randomised controlled trial of early introduction of allergenic foods to induce tolerance in infants (EAT trial)

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In the UK 6% of children under the age of 6 years will develop food Allergies (FA), 25% eczema, 20% asthma and 10% allergic rhinitis (AR). DH guidelines advise exclusive breast feeding (EBF) for the first 6 months and delayed introduction of allergenic foods. There is little evidence that this reduces allergic disease. Interventional trials of delayed weaning have consistently failed to reduce FA and atopy. Animal models and preliminary human data demonstrate that high dose oral tolerance to food proteins in early life prevents allergic sensitisation. Three separate studies show that prolonged EBF is a risk factor for developing atopic disease. The trebling of allergic disease since the 1970s has coincided with a two-thirds reduction in early weaning. Thus delayed weaning could promote FA and even other atopic diseases. We propose a randomized controlled study in infants to determine whether early weaning and exposure to food allergens (3 months of age) prevents the development of FA, eczema, asthma and AR. This study will provide an informed basis for future weaning practices in both atopic and normal infants.