Peanut Allergy And Breastfeeding

Peanut Allergy And Breastfeeding

The occurrence of peanut allergies has doubled in the US and other countries that have promoted the avoidance of peanuts during pregnancy, lactation, and infancy. This has led scientists to examine why exactly this has happened. In recent years there has been a reversal in the advice given to mothers who are concerned that their child has developed or could likely develop a peanut allergy.

The most recent recommendations advise that peanuts can be safely consumed by nursing mothers. In fact, it is encouraged that breastfeeding moms eat peanuts and peanut-containing foods to lower the chance of their baby developing an allergy to peanuts, particularly those infants at high risk of developing a peanut allergy such as those with severe eczema, egg allergies, or other food allergies. Infants not at risk of developing allergies can introduce peanut-containing foods from 6 months or according to cultural practices. Studies have shown that introducing peanuts before 6 months does not interfere with the duration or frequency of breastfeeding.

I will further explain the recommendations that divide infants into 3 groups and the advice for each child. It’s important to be aware of the signs and symptoms that may mean your baby is developing an allergy to peanuts.

Could A Peanut Allergy Be Triggered By Breastfeeding

Proteins of foods ingested by the mother can pass into breast milk where they have the potential to trigger an allergic response in an at-risk child who has been sensitized. According to Wambach & Riordan (2016) antigens in human milk have been detected for peanuts where the amount of allergen needed to sensitize or trigger symptoms is minute. A study was carried out to detect peanut allergens in breast milk where 23 women had been asked to consume 50g of roasted peanuts. The results showed that peanut protein was detected in 11 of the 23 women.

How Do You Know If Your Breastfed Baby Has A Peanut Allergy

A breastfed baby with an allergy to peanuts can show 1 or more of the following symptoms. These include:

  • Diarrhea, constipation and/or vomiting
  • Fussiness after a breastfeed
  • Wheezing and asthma
  • rash and/or hives
  • cold-like symptoms such as runny or blocked nose
  • irritable
  • Sore, red and itchy eyes

The severity and number of symptoms can depend how severe the allergy is.

Is It Safe To Eat Peanuts Or Peanut Butter While Breastfeeding

It is safe to eat peanuts, peanut butter, or indeed any foods containing peanuts while breastfeeding your baby. In fact, as mentioned earlier, it is recommended that moms eat peanut or peanut-containing foods as a way to decrease the risk of their baby developing a peanut allergy, particularly young children who are at high risk of developing a peanut allergy such as those with severe eczema or those who have other food allergies. In addition to this, peanuts are a nutritious food that contains important vitamins and minerals such as folate, potassium, magnesium, and iron as well as a good source of protein.

How Long Do Peanuts Stay In Breast Milk

Studies show that peanut proteins can transfer into breast milk in a short space of time. Peanut protein can also remain in breast milk for at least 24 hours. A study by Bernard et al (2014) showed that Ara h 6 (peanut allergen) has been detected in human milk within 10 minutes of ingesting peanuts with peak values observed within the first hour after ingestion. The study goes on to mention that the transfer is long lasting where small quantities of peanut allergens have been detected over a 24 hour period.

Another study by Vadas et al (2001) showed that peanut protein was detected in 10 women within 2 hours of ingesting peanuts and 1 woman within 6 hours.

Does Early Introduction Of Peanuts Not Conflict With Breastfeeding Guidelines

It is recognized that the early introduction of peanut may seem to contradict the recommendations for exclusive breastfeeding through 6 months of age. However, it was found in the LEAP study that introduction of peanut did not affect the duration or frequency of breastfeeding and did not influence growth or nutrition. So to all moms, it’s perfectly safe to introduce peanut before 6 months without worrying whether it will interfere with breastfeeding.

Early Introduction of Peanut To A Breastfed Infants Diet

breastfeeding mother and her infant both holding bread with peanut butter on top

The National Institute of Allergy and Infectious Diseases reports that a clinical trial called the Learning Early About Peanut Allergy (LEAP) was published in 2015. Results showed that introducing peanuts or peanut-containing products into the diets of infants considered high risk for peanut allergy led to an 81% reduction in the subsequent development of the allergy compared to avoiding peanut altogether. This has led to new guidelines recommending children who are at high risk to be introduced to peanuts early in life rather than avoiding any foods containing peanuts.

When Should A Breastfed Baby Be Introduced To Peanuts

In 2016 guidelines were introduced as to when parents should add peanut to their infant’s diet. These guidelines were divided into 3 categories.

Children with a history of other Allergies

Children who are a high risk of developing a peanut allergy include those with an egg allergy or severe eczema (or both). These children are most likely to avoid developing a peanut allergy by introducing peanut or foods containing peanuts into the diet at an early age. The LEAP study showed that 1.9% of high-risk infants who were introduced to peanut-containing foods at an early age developed the allergy by age 5. This contrasted to 13.7% of children developing an allergy who had avoided peanuts altogether.

The guidelines recommend introducing peanut-containing foods between 4-6 months of age. Children in this high-risk group need to see a specialist to draw up a plan as to the safest way to introduce peanuts or if they can be introduced at all. This will involve a series of tests including a sIgE measurement, a skin prick test (SPT) and if necessary an oral food challenge.

Children with a mild to moderate history of eczema

Peanuts should be introduced for those children who have a mild to moderate history of eczema at 6 months. This will also reduce their chance of developing a peanut allergy.

Children with no history of any allergies

Children in this low-risk group who have no signs of eczema or other food allergies can introduce peanuts to their diet at the same time they are introducing other solids into their diet and according to family and cultural practices.

There has been a lot of debate and different opinions as to whether peanuts should be introduced to a nursing mothers diet. For a long time recommendations were to avoid the allergy-causing food to infants fearing their immune system is too immature to fight a potential allergen. However, it is now clear this is no longer the case where peanuts are now encouraged to be eaten by lactating mothers to prevent a peanut allergy from forming. This article discusses how to manage if you have an allergic reaction while breastfeeding.

Wambach, K & Riordan, J (2016) Breastfeeding and Lactation – enhanced fifth edition Jones and Bartlett Learning,Burlington MA

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