Early Life Feeding Choices and the Allergic March

This education is about:

• The allergic march
• Burden of food allergy
• Early feeding choices and food allergy prevention
• The influence of the microbiome on allergic disease 
• Recent evidence on the early introduction of food allergens
• Updates on food allergy management

Why it matters:
Food allergy can cause severe anaphylactic reactions and is associated with a substantial burden for patients and their families. Food allergy may be preceded by other atopic diseases in a progression  known as the atopic march. Over the past several years, nutritional interventions that can reduce the risk of food allergy development have been identified. Providers should be familiar with these evidence-based options so that they can counsel parents on ways to reduce the risk for food allergy in their infants.

• Profile

  Jenifer Lightdale, MD, MPH

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  Jenifer R. Lightdale, MD, MPH, is the associate chief of the Division of Gastroenterology, Hepatology and Nutrition at Boston Children’s Hospital. Dr. Lightdale received her medical degree from Mount Sinai School of Medicine in New York City and completed her residency and internship at the University of California in San Francisco, followed by fellowships at the University of California in health policy, at Harvard Medical School in pediatric gastroenterology, hepatology and nutrition, and pediatric health services research. She received her master’s degree in public health from Harvard School of Public Health.

  Dr. Lightdale specializes in evaluating and treating infants and children with a broad range of gastrointestinal disorders, especially feeding difficulties, abdominal pain, constipation, GERD and food allergies. She is recognized as an international expert in the areas of endoscopic safety and for her significant contributions to national and international guidelines. Dr. Lightdale was a pioneer in the use of hand-on training for teaching the principles of both diagnostic and therapeutic endoscopy in children and she designed curricula that are used internationally.

  In 2022 Dr. Lightdale played a significant role in helping manage a severe shortage of infant formula that resulted from a product recall by a manufacturer with a dominant market share. Recognizing that parents and caregivers were distressed and frustrated with the lack of guidance on appropriate substitutes for the recalled products, Dr. Lightdale developed information on formulas that are safe substitutes for each other. This resource—posted on the website of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN)—was continuously updated, providing physicians, other healthcare providers, and families with information on how best to navigate the formula shortage.

  Dr. Lightdale is the author or coauthor of more than 130 peer-reviewed books, chapters, and articles and is a frequently invited speaker at national and international events. She serves on several committees of the Food and Drug Administration and has held a number of leadership roles in NASPGHN, and currently serves as the organization’s president. She is a member of the medical advisory board of the International Association for Food Protein Enterocolitis, chair of the editorial board of Gastrointestinal Endoscopy, and an ad hoc review for other medical journals including the American Journal of Gastroenterology, BMJ, Pediatrics, Gastroenterology, International Journal of Pediatrics, JAMA, JAMA Pediatrics, Journal of Pediatrics Gastroenterology, and Pediatrics.

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  Jenifer Lightdale, MD, MPH

  Associate Chief, Division of Gastroenterology, Hepatology and Nutrition
  Boston Children’s Hospital
  Professor of Pediatrics
  Harvard Medical School
  Boston, Massachusetts