Updated ASCIA Guideline aims to reduce food allergy risk in infants

Published

Tuesday, January 20, 2026 - 6:00 AM

The Australasian Society of Clinical Immunology and Allergy (ASCIA) Guideline: Infant Feeding for Food Allergy Prevention has been published in Clinical & Experimental Allergy, marking the first major revision since 2016.

The update was undertaken as a collaboration between ASCIA, the National Allergy Council (NAC), the National Allergy Centre of Excellence (NACE), the Centre for Food and Allergy Research (CFAR) and Allergy & Anaphylaxis Australia (A&AA), with funding from the Australian Government, Department of Health, Disability and Ageing.

Australia has the highest rate of childhood food allergy in the world, with one in 10 babies diagnosed before their first birthday.

The new ASCIA Guideline includes 16 recommendations, based on the latest evidence and expert consensus, about how infant feeding practices can help reduce the risk of food allergies in children.

The recommendations have not changed significantly since 2016, with parents still advised to introduce common allergy-causing foods soon after their infant is developmentally ready and has started solid foods. This is usually around six months of age, but not before four months.

A key change is greater focus on peanut and egg introduction soon after babies start eating solid foods, based on new evidence.

The Guideline now recommends offering peanut and well-cooked egg soon after the baby is eating solid foods – rather than introduction by 12 months of age. These foods should be offered in a form that is appropriate for the baby’s feeding development, and continued to be offered at least once a week to help maintain tolerance.

Other changes in advice include guidance on what to do if a baby has a rash around their mouth after eating a food like peanut and egg, and recommendations regarding the temporary use of milk-based infant formula in the first weeks of a baby’s life.

Incorporating the latest evidence

The review of the 2016 Guideline began in 2024 through a collaborative process between all national allergy bodies. The internationally recognised AGREE II framework for developing clinical guidelines was followed, and a systematic evidence review was supported by a formal Delphi process to achieve expert consensus.

The NACE and CFAR Living Evidence team contributed to two comprehensive overviews of systematic reviews relating to infant feeding and food allergy prevention that supported the guideline update. This process led to the development of eight recommendations based on published evidence. The National Allergy Council conducted the Delphi process to support the development of eight additional recommendations through expert consensus.

Since Australian Guidelines changed in 2016, from delaying the introduction of common allergens – including peanut in the first year of life – to early introduction, Murdoch Children’s Research Institute-led studies showed a strong uptake of the recommendations and a 16 per cent drop in peanut allergies as a result. The National Allergy Council SmartStartAllergy study also showed adoption of the ASCIA Guideline.

Next steps

To support parents and healthcare professionals with the new recommendations, updates have been made to the National Allergy Council Nip Allergies in the Bub website, the ASCIA website and A&AA’s National Helpline and translation services.

ASCIA also called for ongoing review of the Guideline as new research emerged. To help support updates to food allergy prevention measures, the NACE, in partnership with CFAR, established the first Living Systematic Review on Vitamin D for the Prevention of Food Allergy and Eczema.

Associate Professor Jennifer Koplin, NACE Evidence and Translation Lead, said as common conditions with no known cures, the prevention of food allergy and eczema is a public health priority.

“We rapidly identify and synthesise the latest global evidence on this and make it openly available through Open Science Framework and the NACE website to help keep clinical guidelines, policy and public health programs up-to-date.”

So far, the NACE food allergy prevention living evidence collection has screened 3181 manuscripts.

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