Babies and Infants (Allergy Guidance)

I beg to move,

That leave be given to bring in a Bill to make provision for a review of allergy guidance relating to the feeding and weaning of babies and infants; and for connected purposes.

Having a child, I am told, is one of the most amazing and fulfilling times of a new parent’s life. I hope to be able to report back to the House on the validity of that claim later in the year. [Hon. Members: “Hear, hear.”] However, it can also be a period of huge anxiety. Parents are reliant on our brilliant NHS through pregnancy and those important first few months of a child’s life. They will be inundated with information via medical professionals, peers, support groups or the internet and will, of course, make the best decisions they can based on the information they have.

This matter is personal to me. As a long-time allergy sufferer expecting my first child, I have been actively seeking out information on how I can best militate against my child growing up with some of the food allergies that I have, and I am not alone.

Rates of allergic disease such as asthma, hay fever and food allergies have been increasing. The UK has some of the highest rates of allergic conditions in the world, affecting more than one quarter of the population. Allergic conditions are one of the most common chronic diseases in childhood. Around 6% of all visits to the GP are due to allergies, and medicines to treat allergic diseases account for 10% of the total GP prescribing budget. The direct cost to the NHS of managing allergic diseases is more than £1 billion per annum, but the cost in reality is likely to be much higher. The cost to individual allergy sufferers and their families is greater still, with huge impacts on their lives, as many of us know all too well—increased anxiety, social isolation and limited opportunities for travel and other experiences, because the health risks are far too high and allergy awareness is far too low. On average, two children in every classroom are affected by food allergies, and food allergy doubled in the UK between 2008 and 2018. The scale of the problem is huge, with allergies impacting every classroom and every GP surgery in the UK.

Having spoken to some of the most noted allergy specialists in the country ahead of today, it is clear to me that the current food allergy guidance for the feeding and weaning of babies and infants should be reviewed, with a particular focus on children who are showing early signs of allergic disease. Better addressing allergies at primary care level is a relatively simple but hugely effective way of moving the allergy conversation towards prevention.

The Government’s new 10-year plan for the NHS rightly demands that focus on prevention. Prevention in allergy is about recognising the key principle that preventing severe conditions from developing, rather than purely focusing on the treatment of those severe conditions, is better for both patients and the financial sustainability of our NHS. Rather than long waits to see allergy specialists and the hope of medical trials once a child has already developed an allergy, which have huge waiting lists and are, sadly, not effective for everyone, improving our approach to allergy in our public health advice and primary care can be the key to preventing children from developing allergies in the first place.

The guidance should be reviewed for a number of reasons: to improve the clarity and consistency of message; to increase awareness; to help to empower healthcare professionals; and to ensure that ethnic minorities are not being put at a disadvantage. However, before I go into detail as to why the evidence suggests we need this review, I want to be clear about what this Bill is not.

Current NHS guidance recommends exclusive breastfeeding for about the first six months of the baby’s life, and that continuing breastfeeding into the baby’s second year or beyond, alongside other foods, is best for their development. The Bill does not contradict that advice. It is not about changing the advice given to the majority of parents; it is only for children who are beginning to show signs of allergy development, such as those with severe eczema and those already showing signs of food allergy. Additionally, any suggestion of early weaning for this cohort of children is to be done alongside breastfeeding. There are no suggestions in the studies that I cite to support the Bill that breastfeeding rates are impacted by altering public health advice to better prevent allergy.

NHS guidance on introducing foods that could trigger allergies shows that delaying the introduction of peanut and eggs beyond six to 12 months may increase the risk of developing an allergy to these foods. The report that this advice is based on is almost 10 years old. Other countries around the world have taken a more aggressive approach to allergy prevention over the past decade, and we in the UK need to learn and adapt based on the outcomes of those different approaches. The medical guidance and evidence from other parts of the world, including the US and some areas of Europe, actually goes further and encourages the early introduction of those allergens, which is particularly the case for children who display allergies early on.

The Learning Early About Peanut allergy study, or LEAP, looked at the introduction of peanut into the diet of infants aged between four and 11 months who were at high risk of peanut allergy, with high-risk infants defined as those with the presence of significant eczema and/or a pre-existing egg allergy. Published 10 years ago now, the study demonstrated that the consumption of snacks containing peanuts by infants who are at high risk of developing a peanut allergy prevents the subsequent development of the allergy. Of the children who avoided peanuts, 17% had developed a peanut allergy by the age of five, while only 3% of the children who were randomised to eating the peanut snack had developed the allergy by the age of five.

In the US, the guidance recommends that parents of children who are believed to be most likely to develop a peanut allergy—infants with severe eczema, an egg allergy or both—introduce these children to peanut-containing food at four to six months, or get a referral to an allergist who will give the child a skin prick test or blood test to check if the child is allergic to peanuts. European guidelines make similar recommendations on the early introduction of peanut and egg between four and six months.

While NHS guidance suggests that delaying the introduction of peanut and eggs may increase the risk of developing the allergy, I believe that more information should be given to parents when their child is showing early signs of allergy. The feedback I have had from speaking to young parents and parents-to-be is too often that the information for these children is too difficult to find, or that the medical professional the parents are engaging with is more likely to take a safety first approach and not encourage the early introduction of allergens.

I believe that a review of the guidance will help to empower our NHS to give the best, most medically appropriate information to parents at a time when they can be at their most anxious. It must be supported by education and awareness campaigns, together with training for the different healthcare professionals who support these new parents so that the advice they give is consistent and reflects best practice.

Finally, as I touched on at the start, I have concerns that the current lack of guidance is most likely to impact young children from ethnic minority families. The evidence suggests that these children are both more likely to develop an allergy and more predisposed to have multiple allergies. As a result, they are more likely to be disadvantaged without clear, unambiguous guidance on how their parents can navigate those first few months.

I ask hon. Members across the House for their support with the Bill so that we can get parents the best allergy advice for their children and so that we can mitigate the effects of, and in many cases ultimately prevent, allergic disease.

That Becky Gittins, Jim Shannon, Chris Bloore, Alex McIntyre, Sarah Coombes, Kirith Entwistle, Jodie Gosling, Maya Ellis, Pam Cox, Claire Hughes, Satvir Kaur and Catherine Fookes present the Bill.

Becky Gittins accordingly presented the Bill.