Comment on Halken et al.

To the Editor, We read with great interest the European Academy of Allergy and Clinical Immunology (EAACI) guideline on prevention of food allergy (FA).1 In particular, recommendation 3.1.2 states “The EAACI Task Force suggests introducing wellcooked hen's egg, but not raw egg or uncooked pasteurized egg, into the infant diet as part of complementary feeding to prevent egg allergy in infants.” The authors declare in advance that only intentiontotreat (ITT) analyses were considered and they cite, in support of the aforementioned recommendation, four studies.2– 5

[1]  M. Morisset,et al.  Primary prevention of food allergy in 2021: Update and proposals of French-speaking pediatric allergists , 2021, Archives de Pédiatrie.

[2]  M. Erlewyn-Lajeunesse,et al.  BSACI 2021 guideline for the management of egg allergy , 2021, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[3]  T. Zuberbier,et al.  Update of the S2k guideline on the management of IgE-mediated food allergies , 2021, Allergologie select.

[4]  A. Muraro,et al.  EAACI guideline: Preventing the development of food allergy in infants and young children (2020 update) , 2021, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[5]  D. Fleischer,et al.  A Consensus Approach to the Primary Prevention of Food Allergy Through Nutrition: Guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical Immunology. , 2020, The journal of allergy and clinical immunology. In practice.

[6]  C. Flohr,et al.  Efficacy of the Enquiring About Tolerance (EAT) study among infants at high risk of developing food allergy , 2019, The Journal of allergy and clinical immunology.

[7]  D. Campbell,et al.  The Australasian Society of Clinical Immunology and Allergy infant feeding for allergy prevention guidelines , 2019, The Medical journal of Australia.

[8]  G. Wong,et al.  Two-step egg introduction for prevention of egg allergy in high-risk infants with eczema (PETIT): a randomised, double-blind, placebo-controlled trial , 2017, The Lancet.

[9]  B. Niggemann,et al.  Randomized placebo‐controlled trial of hen's egg consumption for primary prevention in infants , 2017, The Journal of allergy and clinical immunology.

[10]  Carsten Flohr,et al.  Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants. , 2016, The New England journal of medicine.