eating peanut butter while pregnant or nursing

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I mention this on another post, but thought I would start its own since I have always been curious. My son's doctor mentioned a theroy of why he got pa. I ate peanut butter a lot while pregnant and nursing. Actually with both kids but my youngest was the only one to get the allergy. He said "possibly" exposing him so much before hand could have lead to the severity of the reaction to peanuts now. A medical article a couple years back in JAMA or New England basically said the same thing. ??? did you eat peanut butter while pregnant or nursing. This might have been discussed before, but I am new to the message boards. Thanks--have a great day. Kathy

On Jan 27, 2002

Yes, I ate lots of peanut butter while pregnant and nursing with my first daughter, who is PA. Our allergist also said that she was most likely exposed while breastfeeding, since she had a reaction to her first known exposure to peanut butter. Unfortunately there is no way to know for sure.

On Jan 27, 2002

I am a firm believer that my son's exposure in utero caused his allergies. We have no allergies in either family, and I consumed a whole lot of peanut butter and soy protein shakes (he's also soy allergic) while pregnant. In the beginning of the pregnancy it was the only thing that would stay down and calm morning sickness, so I had a jar of peanut butter in my desk at work. I am convinced that was just too much legume on the developing embryo. My theory!!

On Jan 27, 2002

Kathy,

I believe in the Breast-feeding theory to a point. When my Mom had us kids, she said hardly anyone was breast-feeding. Not too many people had Life Threatning allergies to foods back then. Now, all are soooooo pressured to breast-feed, and more and more children have these allergies. Along, with so many other theories, that combined, perhaps have caused more and more to develop allergies. The only thing I ate during and after is Peanut Butter. No other Nuts. And son is only PA. Go figure.

On Jan 27, 2002

Hi: I have 3 year old triplet boys, I did NOT consume a lot of peanut butter/peanut products while pregnant (not really a huge PB fan) and/or nursing. One of my boys is PA, the others are not. (I nursed and supplemented w/forumula). So, at least for us, the theory does not hold up. Hope you get the input you are looking for. Take care!

On Jan 27, 2002

I rarely ate peanut butter while pregnant or nursing. I did, however, frequently eat lentil soup. My allergist says there is significant cross-reactivity between lentils and peanuts, and I wonder if that may have contributed to my daughter's PA.

On Jan 27, 2002

I ate tons of it while pregnant and nursing. I am very slim so I was boosting my calorie and fat intake as much as possible. My daughter also reacted significantly to her first known exposure. I do not blame myself, though because I had no way of knowing she could be allergic, no family history etc.

Recent publications have stated that the peanut protein does pass through breast milk and should be avoided by nursing mothers if there is a known family history of peanut allergy. Does anyone know if LaLeche has updated their information to include this? They used to highly recommend peanut butter to nursing mothers

On Jan 27, 2002

I ate a nominal amount of peanuts when I was pregnant with both my sons. My second son, who is now 5 1/2 is PA. I truly do not believe that this consumption was causal (and nor does my husband who is an OB-GYN). We do, however, believe that it may have contributed to the severity of his allergy (the thought eats me up). Although research is still underway, my husband does discourage peanut consumption to his patients during pregnancy and while nursing. Studies have shown peanut consumption while nursing passing to the breast milk.

On Jan 27, 2002

The American Academy of Pediatrics came out with a statement somewhere around a year ago telling mothers of allergy-prone children (based on family history or if the baby already has other allergies such as cow milk or soy protein) to refrain from eating anything with peanuts if breast-feeding. When I was nursing my now six year old, this statement had not been made and I ate tons of peanut butter. She has never eaten a peanut or a may contain, and has a very positive skin test and an extremely high CAP-RAST. So she has had no known exposure except for nursing and maybe pregnancy. As far as pregnancy, from what I have read the connection is not as definite. I also ate a lot of peanut butter while pregnant. Most likely, almost all women who ate lots of peanut butter while nursing probably ate lots of peanut butter while pregnant. Maybe they could do a study on children of women who ate peanut butter while pregnant and didn`t breast feed, to see if they have increased incidence of PA.

On Jan 28, 2002

While pregnant for Chris the only food I could eat was Peanut butter. I ate it a million times a day. On the other hand while pregnant for Jennifer I ate a ton of coffee ice cream with chocolate fudge,and she is far from allergic to coffee ice cream. I have talked with a lot of people about the things they lived on while pregnant and their kids have no allergy. As for the breast feeding I never did breast feed any of the three children. There was a time when I blamed myself for his allergy until I stopped and realized that millions of people have eaten a certain food alot while pregnant and had no allergies. I always say the god just made Chris a little more delicatly than some other. This was his way of making sure he got special attention. I tell all my kids they each have their special issues. I just want to say don't blame yourself because it could have been something so much worse than food allergies for us to deal with. take care claire

On Jan 28, 2002

Come on guys, lay this mommy guilt (and breastfeeding bash) to rest!

1) Lots of moms breastfeed and eat peanut butter, even moms with allergies in their families, and their children don't have PA.

2) It cannot be simple genetics because gene pools don't shift as quickly as food allergies have increased. In other words, we are just as allergic genetically as a group as our parents were, but our kids have more peanut allergy. Therefore, there's an environmental trigger or background level increase that's causing the increase in allergies. Many researchers believe that it's environmental or that there's a viral trigger needed (as in diabetes) to get the whole ball of wax started.

3) I do not believe that peanut proteins cross the placenta intact. Makes it tough to sensitize a fetus in-utero. (If you know anything about this, please post!)

4) While the rate of breastfeeding has increased some, it's still dismal. Only a third of moms are still nursing a couple months after leaving the hospital. So, breastfeeding as a *cause* of peanut allergy is pretty farfetched. I'm obviously interested in the topic so I ask every mom of a PA child I know if they breastfed...many didn't at all, and very few did beyond 6 weeks-3 months.

5) Some proteins are passed intact through breast milk, peanuts being one. However, it's just as possible that chronic, low-grade exposure through breastmilk is nature's way of desensitizing children to a food allergy as it is that this is a sensitization pathway. I do know that breastmilk is an important means to helping an infant's gut develop, which may in turn reduce the permiability of the gut lining and hence the "leaking" of allergenic proteins.

I know it's the au courant recommendation to avoid peanuts during nursing and I do (I have another child who is still nursing with no allergies so far, knock wood), but I look at it as a precaution only.

On Jan 28, 2002

I don't think anyone was breastfeeding bashing or mommy guilting either. It was a simple question of whether or did or didn't. I did with both kids and one of them have it. I don't feel guilty that I did eat peanut butter and now my son has an allergy. But do I feel guilty NO, because who knew. 12 years ago not much was known about this, and it still isn't. That is why doctors are making theories. How else will they figure it out unless they look at all the angles. This is the JAMA article which did the unproven study with peanuts and breast milk. [url="http://jama.ama-assn.org/issues/v285n13/rfull/jbr10043.html"]http://jama.ama-assn.org/issues/v285n13/rfull/jbr10043.html[/url] It is just like cancer, it is genetics really and they are trying to figure out a way to stop it. Same with PA, just trying to figure out the common factor, other than heriterdity, if there is no. NO ONE IS TRYING TO MAKE ANY ONE FEEL GUILTY OR BASH ANYONE. Kathy

On Jan 28, 2002

I didn't eat very much peanut butter at all during my pregnancy. I did eat it occassionally the first few months of breastfeeding. My daughter's PA diagnosis was a surprise. The egg and dairy allergy was expected. My daughter's allergist told me to stay away from peanuts, dairy and eggs during my second pregnancy. We'll see what this baby is allergic to soon.

On Jan 28, 2002

Sorry Kathy, I wrote that in a hurry and didn't mean it to come out so pointed...

I was responding in that way because I've seen this topic literally dozens of times over the years on various support boards, and there are a LOT of moms out there who do feel a lot of guilt over eating peanut butter during pregnancy. I've done a lot of research into this topic for exactly that reason - if I did something "wrong" during pregnancy, I wanted to know.

My point was certainly not meant to be interpreted as "there's no genetic component to this disease." My point was that there has *always* been a genetic component, yet peanut and other food allergies are increasing (or at least we think they are). If that's the case, there must be something in our environment that's changed between this generation and the last.

My focus has actually been on our parent's generation. I don't ask "did you nurse your baby" anymore...I ask "did your mother nurse you?" Because many of us were born in the 60's and 70's when the formula makers really kicked into high gear, most of us were not nursed. A provocative question is whether we missed out on some key protective component that's passed in breast milk.

I was not able to get into the JAMA site (it's members-only) but if this was the study that measured peanut protein in breast milk, I'm familiar with it. Presumably though, peanut proteins and other proteins have always been present in breast milk. Yes, peanut consumption has increased, but that doesn't necessarily mean there's a direct causal link between eating more peanut butter and having more peanut allergies. We know that children become allergic just to proteins within a specific weight range and that they become allergic to the proteins that are most prevalent within their cultural diets...but that doesn't explain why more children are becoming allergic.

No one really understands what triggers the immune system to develop abnormally. It may be that our vaccine schedule is confusing the body by introducing all sorts of pathogens too quickly - that we're essentially creating armies that get all ready to fight and then sit around with nothing to do. It may be that our immune systems are constructed to expect parasites and when they don't find them, they "invent" them.

I really like this topic, but I hate to see it go down the "breastfeeding is bad" route (not that you posted that in any way). There's just so much to this topic that no one really knows what to recommend. I think the APA issued the advice as a precaution - if there is harm, then they're covered. If there's no connection between diet while nursing and allergy, then it's just an inconvenience for the mother.

The one thing they do know is that food allergies per se are not specifically "genetic" in the sense of being linked to one gene. Families with food allergies have atopic diseases that manifest differently depending on the individual. I have no allergies, but my sister has diabetes. My husband has allergies and asthma but no food allergies. His mother has rheumatoid arthritis. No one knows why the same genetic predisposition can result in such varied outcomes.

Anyway, obviously a pet topic of mine. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] Sorry again for coming across so strong.

On Jan 28, 2002

There is a great deal of discussion regarding the link between PN allergy and maternal consumption of PNs in the "Take Action" forum under the topic "March of Dimes." As you may recall, in April 2001 the MoD joined forces with the National PN Board to promote PNs as a source of folic acid. With the help of FAAN, CSPI, the New York State Health Department, the New York Nut Allergy Awareness Group, Inc. and the many PeanutAllergy.com subscribers who wrote letters of protest to the MoD, we were able convince the MoD/Nat'l PN Board to pull their misguided campaign materials. The MoD/Nat'l PN Board are supposedly rewriting these materials to include the recommendations of the American Academy of Pediatrics. As of this date, however, I have yet to receive a copy. I'll send a note to my contact at the MoD and let her know that we are still concerned about this issue. If the new materials are available, I'll try to get a copy.

On Jan 28, 2002

Per the website of the American Academy of Pediatrics, here are some excerpts from their policy statement:

"... In one recently reported study, infants at high risk for allergy fed an extensively hydrolyzed formula or breastfed infants whose mothers avoided cow's milk, egg, and peanuts and did not introduce these foods into their infants' diets had a reduced prevalence of all allergic disorders at 1 year compared with the control group fed a standard cow's milk formula.... RECOMMENDATIONS

Breast milk is an optimal source of nutrition for infants through the first year of life or longer. Those breastfeeding infants who develop symptoms of food allergy may benefit from: maternal restriction of cow's milk, egg, fish, peanuts and tree nuts....

Breastfeeding mothers should continue breastfeeding for the first year of life or longer. During this time, for infants at risk, hypoallergenic formulas can be used to supplement breastfeeding. Mothers should eliminate peanuts and tree nuts (eg, almonds, walnuts, etc) and consider eliminating eggs, cow's milk, fish, and perhaps other foods from their diets while nursing. Solid foods should not be introduced into the diet of high-risk infants until 6 months of age, with dairy products delayed until 1 year, eggs until 2 years, and peanuts, nuts, and fish until 3 years of age. No maternal dietary restrictions during pregnancy are necessary with the possible exception of excluding peanuts...."

The above excerpts are from August 2000. It is postulated that the recent increase in peanut allergy is in part due to the increase in breast feeding compared to when we were infants and also the increase in consumption of peanut buter. There are other factors as well. The AAP is certain of the link between PA and peanut consumption while breast feeding, but they are not certain of the link between PA and peanut consumption while pregnant.

Nevertheless, I don`t think anyone needs to feel guilty about breast feeding and eating peanuts, as this information was not available when most of us were breast feeding. Even those who breast fed after August, 2000 may not have been given this information by their pediatrician. I don`t think anyone can be blamed for eating peanut products and breast feeding if they didn`t have this information.

[This message has been edited by Carefulmom (edited January 28, 2002).]

[This message has been edited by Carefulmom (edited January 28, 2002).]

On Jan 28, 2002

Carefulmom, Thanks for posting that info! I never even new they had " Certain" reason to believe that there is a link between PA and breast-feeding. But, you know I still wouldn't tell a Breast-feeding Mom not to eat Peanut Butter. It's just not my job to do. It's like saying "Don't smoke if your pregnant" or "You shouldn't drink alcohol while pregnant" or "You shouldn't do drugs while pregnant" the list goes on....and really if you know for sure these things will harm your fetus..some will still do these things and some may not.

On Jan 28, 2002

I agree with you that each person has to decide what is best for her. Also, it is very hard to meet the increased caloric needs and protein requirements of breast feeding while cutting out all these foods. Most people while breast feeding drink several cups of milk a day. When I was breast feeding, my daughter was allergic to cows milk and soy, so her allergist told me to eliminate milk and soy from my diet. I found it very difficult to eliminate milk and soy which were found in so many foods ranging from salad dressing to rice a roni and still meet the extra 800 calories a day I needed for breast feeding. I had to cut out so many things that I ended up getting light headed frequently and started to lose weight. It was just really hard to do and still maintain my physical health and be sure my milk was adequate. However, I do think that if I were to have another child today, I would cut out peanuts, tree nuts and shellfish, since those allergies tend to be lifelong. I would be less likely to cut out milk and egg unless my baby were already allergic to them, since those allergies are usually outgrown and it is just so difficult to eliminate all major allergens while breast feeding.

[This message has been edited by Carefulmom (edited January 28, 2002).]

On Jan 28, 2002

I consumed jars of peanuts and p/b when I was pregnant and nursing my oldest son who is PA. Of course, when I was pregnant with my youngest son (we don't know what the third child is a boy or girl yet), I did not touch the stuff. He is not PA...however, I drank milk by the gallon with him. I remember telling my husband, "Wow, I think he likes milk...every time I drink it he moves around and kicks for hours." Turns out he is lactose intolerant. It is a pain to deal with but at least it is not life threatening. So now that we are expecting our third I am trying to avoid nuts and milk but am worrying constantly about what allergies this one MAY have.

On Jan 28, 2002

Carefulmom, will you please post the link for that quote? I've looked for something like that before and been unable to find it.

Incidently, while at the AAP site trying to track that down, I ran across this:

"Recent studies, one a randomized and prospectively controlled study of preterm infants followed up for 18 months35 and a second prospective nonrandomized and uncontrolled study of full-term infants followed up for 17 years,36 have demonstrated that breastfeeding exclusively for at least 6 months reduces the risk of later respiratory allergic symptoms and eczema. Although many of the studies that have examined the ability of breastfeeding to delay or prevent allergic disease have significant methodologic shortcomings,22,37 the total of these studies suggests that breastfeeding exclusively has a protective effect, at least in high-risk infants and particularly if it is combined with maternal avoidance of cow's milk, egg, fish, peanuts and tree nuts during lactation.

More definitive prospective studies of the use of alternative formulas for allergy prophylaxis in high-risk infants are needed. However, the prospective studies available that utilized blinded food challenges to confirm allergic symptoms suggest that asymptomatic formula-fed infants at high risk for allergy given alternatives to cow's milk formulas may have a lower future risk of allergic disease or delayed onset of allergic symptoms. In one recently reported study, infants at high risk for allergy fed an extensively hydrolyzed formula or breastfed infants whose mothers avoided cow's milk, egg, and peanuts and did not introduce these foods into their infants' diets had a reduced prevalence of all allergic disorders at 1 year compared with the control group fed a standard cow's milk formula.38 However, at 7 years of age there were no differences in allergic respiratory symptoms between the 2 groups."

Apparently even the experts disagree.

[url="http://www.aap.org/policy/re0005.html"]http://www.aap.org/policy/re0005.html[/url]

On Jan 28, 2002

Oops, never mind. I just realized that my quote is just the more complete version of yours!

On Jan 28, 2002

Brought up a related thread under Living with PA. (Colic & PA.)

In brief: breastfed PA child for nearly 1 year while consuming 2 PBJ's per day, on average. Will always feel some responsibility for child's PA.

Currently breastfeeding 2nd child (PA status unknown) & plan to at least go 1 year. NO peanut in diet & working hard to consume ANYTHING in moderation. Totally different infant experience this time: happy, no eczema, sleeps great, RARELY cries.

Very pro-breastfeeding. Totally anti-peanut.

Just my nickel on the grass. EB

And I was breastfed up to 1 year.

On Jan 29, 2002

I didn't realize JAMA stopped having free access. I have access to it at work. I run a medical library, so if anyone ever needs anything looked up let me know. here is the abstract....from the jama article if you want the whole thing email me [email]Kdorsey04@yahoo.com[/email]

Detection of Peanut Allergens in Breast Milk of Lactating Women Peter Vadas, MD, PhD; Yvonne Wai, MD; Wesley Burks, MD; Boris Perelman, PhD

Context Most individuals who react to peanuts do so on their first known exposure. A potential but unproven route of occult exposure resulting in sensitization to peanut is via breast milk during lactation.

Objective To investigate the ability of maternal dietary peanut protein to pass into breast milk during lactation.

Design and Setting Clinical investigation conducted at 2 North American hospitals from March 1999 to October 2000.

Patients Twenty-three healthy, lactating women aged 21 to 35 years.

Intervention Each woman consumed 50 g of dry roasted peanuts, after which breast milk samples were collected at hourly intervals.

Main Outcome Measures Presence in breast milk of total peanut protein, analyzed by a sandwich enzyme-linked immunosorbent assay, and 2 major peanut allergens, Ara h 1 and Ara h 2, detected by immunoblot analysis.

Results Peanut protein was detected in 11 of 23 subjects. It was detected in 10 subjects within 2 hours of ingestion and in 1 subject within 6 hours. The median peak peanut protein concentration in breast milk was 200 ng/mL (mean, 222 ng/mL; range, 120-430 ng/mL). Both major peanut allergens Ara h 1 and Ara h 2 were detected.

Conclusions Peanut protein is secreted into breast milk of lactating women following maternal dietary ingestion. Exposure to peanut protein during breastfeeding is a route of occult exposure that may result in sensitization of at-risk infants.

JAMA. 2001;285:1746-1748

On Jan 29, 2002

Thanks Kathy! Nice perk at work!

Here's the thing though...I was never debating whether peanut proteins are passed through breastmilk or whether children can become sensitized to the allergy if the mom eats peanuts. That would seem to be pretty straightforward.

However, babies seem to essentially be allergic to peanuts *before* they ever see them. If a child is going to be allergic to a bee sting, the allergy will never manifest itself unless/until he's stung. Does that make him less "allergic" since his body is all primed to be allergic when and if he's stung?

A lot of the studies on breastfeeding say that delaying solids and eliminating allergenic proteins in breastmilk can DELAY the onset of allergies. They also say that breastfeeding in general can reduce the severity of allergic disease overall. Nowhere though have I read that if you have a child with food allergies, they could have been *prevented* if you didn't eat allergenic proteins while nursing. I think that's a misleading and potentially guilt-inspiring conclusion, and as I said earlier, I think there's a lot of sensitivity from moms who thought they did a good thing by breastfeeding and are now interpreting these studies to mean breastfeeding is bad.

Does anyone know if there have been any studies done to measure IgE levels at birth in newborns from atopic families and then track those infants to see what types of disease develops? Now THAT would be interesting to see!!

P.S. As I mentioned, I do avoid peanuts, tree nuts, fish and shellfish while nursing. Wouldn't want anyone to interpret my posts as not being in favor of this path! While I think that they may find it only delays or redirects allergic disease, having a few food allergy-free years would be nothing to sneeze at!

On Jan 29, 2002

ask and you shall recieve.:} This is a recent medical journal article, but it is very medical...... A great place to look for things is the national library of medicine. This is where all the journal articles from just about every medical journal gets put on the database so doctors can look up different topics. [url="http://www.pubmed.gov"]www.pubmed.gov[/url] just put in your keywords and see what comes up. some have link outs for full text but most don't. Many times just reading the abstracts help Another site more lay persons language (my type of site) witht he National LIbrary of Medicine is [url="http://www.medlineplus.gov"]www.medlineplus.gov[/url] search with keywords here also. here is the abstract below. Kathy

: Rocz Akad Med Bialymst 2000;45:87-95 Related Articles, Books, LinkOut

Natural course of sensitization in children: follow-up study from birth to 6 years of age, I. Evaluation of total serum IgE and specific IgE antibodies with regard to atopic family history.

Oldak E, Kurzatkowska B, Stasiak-Barmuta A.

Department of Pediatric Infectious Diseases, Medical Academy of Bialystok.

The aim of the study was to evaluate the total serum IgE level and specific IgE antibody responses to alimentary and environmental allergens in the birth cohort of Polish children followed-up from birth to 6 years of age with regard to atopic family history. To study enrolled 52 children. Every child underwent physical examination and in vitro allergy testing at birth, in 6, 12 months of life and in 6 years of age. The mean total serum IgE level was higher in children with atopic family history compared to the children without genetic propensity in every time point, but difference was statistically significant only in six years of age. The highest incidence of positive RAST tests to food allergens was observed in one year of age, mainly in children with atopic family history (36.5%) compared to those without such a history (23.6%). By the age of six years, sensitization to food allergens was observed less frequent in both of the study groups (17.2% and 15%, respectively), whereas the sensitization rates to inhalant allergens were about 53% in tested children with atopic family history compared to 19% in children without such a history.

Publication Types: Clinical Trial Controlled Clinical Trial

On Jan 29, 2002

Kathy, you are a woman after my own heart! Thanks for posting that one.

Here's the discussion from a report I ran across while searching for the full discussion on yours:

**********

Discussion Breast-feeding must be strongly recommended because it is the most natural way of nutrition for the infant. Among the many reasons given are the protection against infections and a closer mother-child bond. The quality of air, water and food in today

On Feb 7, 2002

Our story: As a vegetarian urged to eat lots of protein "for the baby" - and a confirmed peanut butter lover, I ate a peanut butter sandwich with a glass of milk for breakfast 5 days out of 7 when pregnant, and for the first 2 months after our son was born (we're talking at least one 18-oz jar of peanut butter every 2 weeks). After weeks of "colic", I read in The Baby Book, by Dr. William Sears about food sensitivities to things in Mom's diet causing baby's tummy problems. He mentioned peanut and milk products among the most common offenders. Within 2 weeks of cutting out milk and peanut products, baby was much better. At 11 months, we learned that he was peanut allergic. Until he was 2 years old, he couldn't drink or eat foods that contained milk that hadn't been cooked. Coincidentally, there are NO food allergies in either my family or my husband's. I sincerely believe that the volume of peanut butter I ate resulted in his allergy. If/when we have another child, I will be much more careful about going overboard with any one food.

On Feb 10, 2002

Okay, here's my 2 cents worth.

I ate peanut butter while pregnant and while breastfeeding first child who is PA and reacted at first known exposure when he was 11 months old.

Consulted allergist when I became pregnant with my second child about how to try to prevent PA this time around. She suggested I eliminate peanuts, tree nuts, and shellfish from my diet while pregnant and nursing since these are the foods most likely to cause severe allergic reactions. And the baby shouldn't have any of them til after age three. She also said to breast feed exclusively for six months. My son will be 6 months old on March 2nd. So far, so good. We'll see what happens down the road.

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