Leading the way on COVID-19

Reducing children’s allergies

Australia’s unwanted title as the world’s food allergy capital is finally under threat thanks to new Murdoch Children’s research.

Feeding guidelines change behaviour

An MCRI-led study found that food allergy guideline changes have now led to a 16 per cent drop in infant peanut allergy. Significantly more parents were also feeding their babies peanuts. International infant feeding guidelines changed in 2016 to recommend introducing peanut and other allergenic foods before 12 months. Murdoch Children’s PhD candidate and study lead Victoria Soriano said this research was the first to test the approach in homes and measure the guidelines’ impact on peanut allergies. She said despite initial concern that parents might not follow the new advice, uptake was high. Peanut consumption by 12 months increased from 28 per cent to 89 per cent in the 10 years to 2019, with severe allergic reactions to early introduction uncommon. The study found peanut allergy prevalence among infants was 2.6 per cent in 2018-19, down from 3.1 per cent in 2007-11. Australia still has the world’s highest reported childhood food allergy rates – about one in 10 infants and one in 20 children aged up to five years has a food allergy. Most parents know that peanuts are particularly problematic, but fewer know about potential allergies to tree nuts – including cashews, almonds, walnuts and hazelnuts. Tree nuts are one of the most common foods causing acute allergic reactions and nearly all tree nuts have been associated with fatal allergic reactions. To address this, Murdoch Children’s Dr Vicki McWilliam and Associate Professor Kirsten Perrett have commenced the TreEat study, which is enrolling children with a confirmed peanut allergy, to see how a multi-nut diet compares with at-home introduction of a single tree nut.

Repurposing old vaccines to reduce allergies

Could the solution for allergies be hiding in plain sight? New research has found repurposing vaccines might help. The Murdoch Children’s-led study found a century-old tuberculosis (TB) vaccine could help reduce the incidence of eczema in high-risk infants due to its helpful off-target effects. The Bacille Calmette-Guérin (BCG) vaccine was used in Australia until the 1980s to prevent TB. The trial found it had a modest effect in preventing eczema in high-risk infants. However, there was insufficient evidence to recommend a neonatal BCG vaccination for all infants. The benefit was greater in children whose parents both had hay fever, asthma or eczema. A single dose of BCG soon after birth reduced their eczema incidence by 25 per cent. Part of the long-running Melbourne Infant Study: BCG for Allergy and Infection Reduction (MIS BAIR), the project was based on the idea that BCG vaccines stimulate the immune system to better fight infections and be less allergy prone. The team is following these babies over their first five years to investigate BCG’s effect on respiratory tract infections, allergies and asthma.

Whooping cough trial

Another innovative trial is investigating whether an older whooping cough vaccine could help prevent allergies in early childhood. The OPTIMUM Study, conducted by Murdoch Children’s, the Telethon Kids Institute and The Children’s Hospital at Westmead, is recruiting infants aged 6-12 weeks. It is investigating whether a single dose of the discontinued ‘whole cell’ whooping cough vaccine at two months, instead of the current ‘acellular’ whooping cough vaccine, can help protect children against food allergies and eczema. Researchers want to know whether the whole cell whooping cough vaccine can train the immune system to recognise the difference between harmful germs and things it could mistakenly treat as a threat such as food.

Staying smart about dummies

Sterilising dummies has been linked to increased food allergies in babies at 12 months. The Institute-led study with Deakin University compared dummy use and cleaning methods among more than 700 infants at six months and those with a confirmed food allergy at one year. Infants whose dummies were sterilised with antiseptic were more likely to have a diagnosed food allergy at 12 months. There was no increased food allergy risk at one year among dummy users when the dummies were washed in tap water, boiling water, put in the parent’s mouth, or not washed at all. Centre of Food and Allergy Research co-lead, Associate Professor Kirsten Perrett, said the link warranted further research into how good bacteria in the infant mouth and gut could help prevent food allergies. But she noted it was still important to clean dummies to prevent infectious diseases. Hear Kirsten explain how her research is working to prevent food allergy