Primary prevention of food allergy in young children: Update and proposals of French-speaking pediatric allergists belonging to the "Food Allergies" working group of the French Society of Allergology

In recent years, pediatric allergists have observed a worrying increase in cases of food allergies and anaphylaxis in younger and younger children with polyallergies and polysensitizations, involving allergens with high anaphylactic potential, such as peanuts and nuts, greatly impacting the quality of life and the future of these children. After reviewing the current epidemiological data, we discuss the main causes of food allergies increase (including the hygienic hypothesis, the role of the intestinal microbiota and epigenetic modifications), data from studies on the skin barrier and its fundamental role in the development of sensitization and food allergies, data concerning the tolerogenic digestive tract applied in particular to eggs and peanuts, but also data concerning the prevention of allergy to cow???s milk proteins. In the light of these studies, we make practical propositions focused on infants. They concern the date of the introduction of cow???s milk, the early treatment of eczema and a broad food diversification, from 4 months, including food allergens with high allergic risk such as peanuts and nuts if consumed by family. ?? 2022 Elsevier Masson SAS. All rights reserved.