Table 1 Comparing the 2000 and 2008 AAP Statements on the timing of introduction of complementary foods

No maternal dietary restrictions during pregnancy are necessary with the possible exception of excluding peanuts.

Lack of evidence that maternal dietary restrictions during pregnancy play a significant role in the prevention of atopic disease in infants.

Infants at high risk of allergy should be breastfed or given a hypoallergenic formula.

1. Infants at high risk of allergy that are exclusively breastfed, on extensively hydrolyzed or partially hydrolyzed formula, for at least 4 months have a decreased incidence of atopic dermatitis.

2. Extensively hydrolyzed formulas may be more effective than partially hydrolyzed in the prevention of atopic disease.

3. Amino-acid base formulas for atopy prevention have not been studied.

4. No convincing evidence for the use of soy-based infant formula for the purpose of allergy prevention.

Infants at high risk of allergy that are exclusively breastfed for at least 4 months have a decreased incidence of cow milk allergy in the first 2 years of life.

Infants at high risk of allergy that are exclusively breastfed for at least 3 months are better protected against wheezing in early life; no evidence that this protects against allergic asthma after 6 years old.

Mothers should eliminate peanuts and tree nuts (almonds, walnuts, etc) while nursing.

Lack of evidence that maternal dietary restrictions while nursing play a significant role in the prevention of atopic disease in infants.

Mothers should consider eliminating eggs, cow's milk, fish from their diets while nursing.

Infants at high risk of allergy should have dairy products delayed until 1 year, eggs until 2 years and peanuts, nuts and fish until 3 years (no evidence presented).

Solid foods should not be introduced before 4 - 6 months of age, but there is no current convincing evidence that delaying their introduction beyond this period has a significant protective effect on the development of atopic disease. This includes the delay of foods considered to be highly allergic such as fish, eggs, and foods containing peanut protein. For infants older than 4 to 6 months old, there is insufficient data to support a protective effect of any dietary intervention for the development of atopic disease.