What does the latest research say about infant feeding and food allergies?

Recent research, including an Australian study published in the journal of Allergy and Clinical Immunology: In Practice , confirms that early introduction of allergenic foods lowers the prevalence of IgE antibody-mediated allergies to egg, peanut, and cow's milk. The American Academy of Pediatrics also supports this approach in their updated guidance on food allergies.

How effective is providing updated feeding guidelines to parents?

Providing clear explanations and written copies of updated feeding guidelines to parents at the time of solid food introduction is critical. A study showed a marked betterment in allergy rates when parents received direct guidance, compared to those who received no such advice. This proactive approach encourages earlier introduction of allergenic foods.

What are the key allergenic foods that should be introduced early?

key allergenic foods to introduce early include peanuts,eggs,and cow's milk. Introducing these foods in a safe form (e.g., peanut butter thinned with water, well-cooked eggs) around 4-6 months of age can help reduce the risk of developing allergies. Always consult with a pediatrician or allergist for personalized advice.

What should parents do if they are anxious about introducing allergenic foods?

It's understandable for parents to be anxious. Targeted education from healthcare professionals, along with clear reinforcement that the updated guidelines apply to all infants regardless of allergy risk, can definitely help alleviate concerns. Positive feedback from parents indicates that feeling supported and having the ability to ask questions is crucial.

Are there any gaps in the current knowledge about early food introduction?

Yes, there is still a gap in knowledge surrounding the frequencies and amounts of consumption of food allergens. Tolerance may depend on how often and how much of these foods are eaten regularly. Future studies should regularly capture this data to provide more complete guidance.

Why is screening for interstitial lung disease (ILD) vital in SSc and MCTD patients?

systematic screening for ILD allows for earlier detection and intervention, perhaps improving outcomes for patients with systemic sclerosis (SSc) and mixed connective tissue disease (MCTD).

What screening method is recommended for interstitial lung disease (ILD)?

High-resolution computed tomography (HRCT) is strongly recommended for screening ILD in at-risk patients.

Are there specific monitoring recommendations after an interstitial lung disease (ILD) diagnosis?

Yes, monitoring recommendations are disease-specific and stratified by risk of ILD progression, with varying frequencies of lung function tests depending on the patient's risk profile.

what are the new treatment recommendations for interstitial lung disease (ILD) related to connective tissue diseases?

The guidelines offer specific treatment options for different connective tissue diseases, including tocilizumab for SSc-ILD and immunosuppressive treatments for IIM-ILD.

What connective tissue diseases should be screened for interstitial lung disease (ILD) according to the new guidelines?

The guidelines recommend screening for ILD in systemic sclerosis (SSc), mixed connective tissue disease (MCTD), rheumatoid arthritis (RA), idiopathic inflammatory myopathies (IIM), and Sjögren's disease (SjD).

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Q: Why is early introduction of allergenic foods important for infants?

Early introduction of allergenic foods, such as peanuts and eggs, can significantly reduce the risk of developing food allergies in infants. Studies have shown that introducing these foods between 4-6 months of age, when the infant is developmentally ready, can help build tolerance and prevent allergic reactions.

Health

Dietary Advice for Moms Reduces Infant Allergies: New Study

by Dr. Michael Lee – Health Editor June 27, 2025

written by Dr. Michael Lee – Health Editor

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Early Infant Feeding Advice Significantly Reduces Food Allergies, Study Shows

Table of Contents

Early Infant Feeding Advice Significantly Reduces Food Allergies, Study Shows
- Australian Study Confirms Benefits of Early Allergen Introduction
  - Study Design and Key Findings

Providing parents with updated infant feeding advice, particularly regarding the early introduction of allergenic foods, dramatically reduces the progress of food allergies in the first year of life. A recent study adds to a decade of research showing the benefits of introducing foods like eggs and peanuts when first starting solids.

Australian Study Confirms Benefits of Early Allergen Introduction

An Australian study published in the Journal of Allergy and Clinical Immunology: In Practice, examined the impact of updated infant feeding guidelines on the prevalence of immunoglobulin E (IgE) antibody-mediated allergies. The study found that early introduction of allergenic foods significantly lowered the rates of egg, peanut, and cow’s milk allergies. The research also emphasized the importance of ensuring parents receive and understand the latest dietary guidance on food allergy prevention [[source]].

did You Know? The American Academy of Pediatrics also supports the early introduction of perhaps allergenic foods into infant diets [[source]].

Study Design and Key Findings

The study, led by Debra Palmer, PhD, compared two infant cohorts born before and after the implementation of Australia’s infant feeding and allergy prevention guidelines in 2016. All babies had a high familial risk for allergies, with a first-degree relative having a history of allergic disease.

In the first cohort (506 infants born 2006-2014),families received no specific feeding advice. In the second cohort (566 infants born 2016-2022), families received updated infant feeding and allergy prevention guidelines when the infants were 6 months old.

By 12 months of age, the vast majority of infants in the second cohort had been introduced to peanuts (94.2%), eggs (99.3%), and cow’s milk (98.6%).

The results showed a notable reduction in food allergies in the second cohort. The combined prevalence of IgE-mediated peanut, egg, and cow’s milk allergies was just 4.1% in cohort 2, compared to 12.6% in cohort 1. This represents an adjusted odds ratio (aOR) of 0.28 (95% CI, 0.16-0.48; P < .001).

Individual allergy prevalence also decreased significantly:

Peanut: 1.1% in cohort 2 vs 5.8% in cohort 1 (aOR, 0.24; 95% CI,0.08-0.76; P = .015)
Egg: 2.8% in cohort 2 vs 11.7% in cohort 1 (aOR, 0

June 27, 2025 0 comments

Health

Early, Aggressive BP Lowering Tied to Better ICH Outcomes

by Dr. Michael Lee – Health Editor June 19, 2025

written by Dr. Michael Lee – Health Editor

Aggressive Blood Pressure Control Improves Stroke Outcomes

Early Intervention is Key for Better Recovery and Reduced Risks

New research reveals that swiftly lowering blood pressure after an intracerebral hemorrhage (ICH) can significantly improve patient outcomes, potentially saving lives. Prompt treatment, especially within the first few hours, leads to better neurological function, fewer adverse events, and reduced mortality rates for those suffering from this type of stroke.

Early Treatment Yields Stronger Results

A pooled analysis of four Intensive BP Reduction in Acute Cerebral Hemorrhage Trials (INTERACT1-4) has confirmed the benefits of early, intensive blood pressure management for individuals experiencing ICH. The most positive results were found when the intervention was administered within three hours of the onset of ICH symptoms. Current guidelines suggest a systolic BP target of less than 180 mm Hg within one hour of symptom onset, whereas the intensive treatment approach aims for less than 140 mm Hg within the same timeframe.

The studies involved over 10,000 adults with acute ICH. Participants were randomly assigned to receive either intensive or guideline-recommended BP-lowering treatment within an hour of symptom onset. The primary outcome measure was functional recovery, determined using the modified Rankin scale. The intensive treatment group showed significantly lower mean systolic BP rates at one hour compared to the guideline group, 149.6 mm Hg versus 158.8 mm Hg, respectively.

“The data presented make a compelling case for ultra-early intensive blood pressure reduction as a potentially useful intervention to improve outcomes in people with acute ICH.”

—David J. Werring, PhD, Department of Translational Neuroscience and Stroke, University College London Queen Square Institute of Neurology, London

Those receiving intensive treatment also experienced reduced odds of neurological deterioration within seven days, along with fewer serious adverse events and deaths. According to the American Stroke Association, stroke is a leading cause of death in the United States, with nearly 800,000 strokes occurring annually (American Stroke Association).

Timing and Impact on Hematoma Growth

Investigators also assessed the impact of treatment timing and its effect on hematoma volume. Results from a CT substudy of almost 3000 participants revealed no significant effect on either relative or absolute hematoma growth in the initial 24 hours between intensive and guideline treatment approaches. However, when intensive BP lowering began within three hours of symptom onset, functional recovery improved, and hematoma growth was reduced in almost a quarter of patients.

Expert Insights

In an accompanying editorial, David J. Werring noted the importance of considering the specific pathophysiology of ICH, where hematoma expansion plays a major role in the first few hours. He suggested that intensive BP lowering could be a useful intervention to improve outcomes for individuals with acute ICH, emphasizing the need for further research.

The analysis was funded by a multitude of organizations worldwide, and the investigators disclosed various financial relationships. Despite the limitations of the study, the results underscore the critical importance of early intervention in managing ICH. More research is warranted, but the current findings strongly support the idea that, as Werring concluded, “time is brain” for those with ICH.

June 19, 2025 0 comments

Health

EULAR/ERS Guideline: Managing CTD-ILD – New Recommendations

by Dr. Michael Lee – Health Editor June 15, 2025

written by Dr. Michael Lee – Health Editor

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New Guidelines Call for Increased Interstitial Lung Disease Screening in Autoimmune Patients

Table of Contents

New Guidelines Call for Increased Interstitial Lung Disease Screening in Autoimmune Patients

BARCELONA, Spain – In a move set to reshape clinical practice, the European Alliance of Associations for Rheumatology (EULAR) and the European Respiratory Society (ERS) have jointly released new guidelines advocating for systematic screening of interstitial lung disease (ILD) in all patients diagnosed with systemic sclerosis (SSc) and mixed connective tissue disease (MCTD). The declaration was made at the EULAR 2025 Annual Meeting.

These complete, disease-specific recommendations aim to standardize the screening, diagnosis, and management of ILD across various connective tissue diseases (CTDs), including SSc, MCTD, rheumatoid arthritis (RA), idiopathic inflammatory myopathies (IIM), and Sjögren’s disease (SjD).The guidelines mark a notable step forward, representing the first collaborative effort between rheumatologists and pulmonologists in Europe to address ILD in this patient population.

Screening Recommendations for Interstitial Lung Disease

the cornerstone of the new guidelines is the strong recommendation for systematic ILD screening using high-resolution computed tomography (HRCT) in all SSc and MCTD patients, irrespective of pre-existing risk factors. This recommendation extends to patients with IIM, excluding those with inclusion body myositis. For individuals with RA,SjD,and other CTDs,the guidelines advise an initial assessment for disease-specific risk factors,followed by HRCT screening for those with identified risks.

Did You Know? The American Thoracic Society estimates that ILD affects approximately 15% of patients with rheumatoid arthritis[[1].

While previous recommendations supported screening in SSc, the inclusion of RA patients with risk factors marks a significant expansion. According to Dr. Bernhard Hellmich, this broadened scope is expected to identify more patients who could benefit from early therapeutic intervention, potentially leading to improved long-term outcomes.

Notably, the guidelines do not specify a screening frequency due to limited evidence. Dr. Anna-Maria Hoffmann-Vold suggests mirroring the diagnostic approach and reassessing for new ILD progression risk factors. The guidelines explicitly advise against substituting HRCT with pulmonary function tests or lung ultrasound for initial screening. However, forced vital capacity and diffusing capacity of the lungs for carbon monoxide can be incorporated in the presence of symptoms or CT abnormalities.

Monitoring ILD Progression After Diagnosis

The guidelines provide specific timeframes for monitoring ILD progression post-diagnosis, tailored to individual diseases and stratified by ILD progression risk. Clinicians are advised to assess risk based on prior lung function tests, HRCT results, the 6-minute walking test, and risk factors such as disease-specific circulating markers, disease activity, and HRCT patterns.

Based on these assessments, patients are categorized as high or low risk. Monitoring frequency varies accordingly. for high-risk patients with any CTD, lung function tests are recommended every 3-6 months during the initial years, followed by every 6-12 months thereafter. Lower-risk patients should undergo lung function tests every 6-12 months initially, and then annually.

Treatment Strategies for Interstitial Lung Disease

the new guidelines offer detailed treatment recommendations, outlining available options for each disease and providing guidance on selecting the most appropriate medication for individual patients. The guidelines strongly recommend tocilizumab for SSc-ILD patients with early diffuse SSc and signs of inflammation. For IIM-ILD patients, immunosuppressive treatment, including glucocorticoids, calcineurin inhibitors, rituximab, mycophenolate, or azathioprine, is recommended.

Other treatment recommendations are conditional, reflecting limited patient populations and a scarcity of randomized controlled trials. Individual treatment algorithms are provided for SSc-ILD, RA-ILD, and IIM-ILD.

Dr. Hellmich believes that these comprehensive guidelines will facilitate earlier treatment initiation, potentially improving patient prognosis. He noted that the inclusion of certain therapies in the EULAR guidelines may encourage their use in clinical practice,even if they are currently considered off-label.

Pro Tip: Staying informed about the latest research and guidelines is crucial for providing optimal care to patients with connective tissue diseases and interstitial lung disease.

The full guidelines are slated for publication next month in the Annals of the Rheumatic Diseases and European Respiratory Journal.