《2026澳大利亚和新西兰临床免疫与过敏学会“预防食物过敏的婴儿喂养指南”》解读

Interpretation of infant feeding for food allergy prevention guideline released by Australasian Society of Clinical Immunology and Allergy in 2026

摘要

2026年澳大利亚和新西兰临床免疫与过敏学会(ASCIA)发布的《预防食物过敏的婴儿喂养指南》,是对2016年版做了重要更新。该指南采用AGREE Ⅱ框架、AMSTAR 2工具及GRADE分级体系,共形成16项建议(8项基于已发表证据,8项基于德尔菲法专家共识)。主要更新内容包括:明确建议在婴儿发育准备就绪后(约6月龄,不早于4月龄)引入辅食,并尽快添加煮熟的鸡蛋和适宜形式的花生;新增了口周皮疹处理建议,以避免不必要的食物回避;强调出生后第一周内避免临时补充普通牛奶配方粉,除非有明确医学指征。本文系统解读该指南的核心建议,对比其与2016年版及我国《中国儿童食物过敏循证指南(2022)》的异同,并重点围绕花生引入的本地化策略、剖宫产婴儿早期配方奶管理、口周皮疹的临床鉴别等关键问题,结合循证原则提出适用于我国的具体实操建议,供儿科临床参考。

Abstract

The Australasian Society of Clinical Immunology and Allergy (ASCIA) released the 2026 Guideline: Infant Feeding and Food Allergy Prevention, providing a significant update to the 2016 version. Developed using the AGREE Ⅱ framework, AMSTAR 2 tool, and the GRADE system, the guideline presents 16 recommendations, comprising eight evidence-based and eight consensus-based statements derived via the Delphi method. Key updates include: 1) recommending the introduction of complementary foods when the infant is developmentally ready (approximately at 6 months, but not before 4 months); 2) introducing hard-boiled eggs and suitable forms of peanuts as soon as possible; 3) introducing management protocols for perioral rashes to prevent unnecessary food avoidance; 4) emphasizing the avoidance of occasional cow's milk formula supplementation during the first week of life unless there is a clear medical indication. This paper systematically interprets the core recommendations of this guideline, compares its similarities and differences with the 2016 edition and Chinese evidence-based guideline for childhood food allergy (2022). Furthermore, it provides localized clinical strategies for the Chinese context, focusing on peanut introduction, formula management for cesarean-born infants, and the differential diagnosis of perioral rashes, aiming to offer evidence-based practical guidance for pediatricians.

关键词

婴儿喂养 / 食物过敏 / 预防 / 指南解读

Key words

infant feeding / food allergy / prevention / guideline interpretation

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基金资助

国家重点研发计划(2021YFC2701800,2021YFC2701801)