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Don't Pass the Peanuts

Peanut Allergies and Breastfeeding

By Debora Geary

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Having a child with peanut allergy can be very scary. I have personal experience with this. Both of my sisters' oldest children are allergic to peanuts. It changes the experience of taking my niece or nephew to Dairy Queen for ice cream when I know that an accidental peanut might be fatal. Going to the park is hazardous – what if they go down the slide after the toddler with sticky fingers from her lunchtime peanut butter and jam sandwich?

Now that I'm pregnant with my first child, I wanted know if there was anything I could do to reduce the risk of my baby having peanut allergy. I discovered that while the scientists and doctors are waiting for harder evidence, many moms are in the dark about this very deadly allergy and what they can do about it.

How Serious is Peanut Allergy?
Peanut allergy is not as rare as you might think. Dr. Scott Sicherer, pediatric food allergy specialist at the Mount Sinai School of Medicine in New York, says that about one in 150 children are affected by peanut allergy, and that number is rising.

Peanut allergy is more common in families with a history of peanut allergy or allergies in general. Unlike many other food allergies, children don't usually outgrow their reaction to peanuts. It is a particularly scary allergy, because reactions are often severe, and accidental ingestion of peanuts is fairly common – traces of peanuts can be found in ice cream, cereal, baby formula, candy, donuts and many other foods. Just check for labels that say "may contain traces of peanuts."

How Can Peanut Allergy Be Avoided?
Many food allergies can be avoided or lessened in severity by delaying the introduction of high-risk foods. The American Academy of Pediatrics recommends waiting until children are a year old to introduce dairy products, 2 years for eggs and 3 years for peanuts, nuts and fish. So it would seem that the simple answer to reducing peanut allergy is to keep the peanut butter and jam sandwiches out of your child's diet for a few years.

However, there is a growing concern that breastfeeding mothers may be sensitizing their infants to peanuts. Recent research by allergists at St. Michael's Hospital in Toronto, Canada, discovered that when moms eat peanuts, within two hours, peanut proteins can often be found in their breast milk, including the two peanut proteins which are most likely to cause an allergic reaction. While not all babies will develop allergies from this exposure, the concern is that high-risk infants (those with a family history of allergies) might react to this early exposure to peanuts, perhaps developing the allergy or a more severe allergy than they might have gotten otherwise.

Should breastfeeding moms, particularly those with a family history of allergies, avoid peanuts? "I do not believe that we have a clear knowledge of the impact of breastfeeding on peanut allergy," Dr. Sicherer says. "It has been supposed that when a breastfeeding mother ingests peanut, since some may pass through the milk to the infant, that this may 'cause' the allergy. There is some circumstantial evidence that this may be the case. On the other hand, a careful reading of the available literature does not convincingly show a relationship."

In other words, he's not convinced that avoiding peanuts while breastfeeding will reduce the chances of your baby having a peanut allergy.

In other countries, governments and the medical establishment have taken a stronger stance. While the evidence is not conclusive that breast milk containing peanut proteins can lead to allergies, several countries have clear recommendations in place for breastfeeding women. For example, the governments of both Britain and New Zealand recommend that women with a family history of allergy (asthma, hay fever, eczema) avoid peanuts while both pregnant and breastfeeding.

What Moms Have to Say
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