Pregnant--what would you do?

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**Sorry, I posted this in the wrong section before**

My best friend is a nurse at Children's Memorial Hospital in Chicago. She was working with a doctor who just got off her allergy rotation and they were discussing allergies the other day. She mentioned that my son (her godson) has PA, and that I'm 5 months pregnant and not consuming any peanut products in hopes to keep this next child PA-free. This doctor said "OH NO!! It's now strongly believed that mothers SHOULD consume peanut products when they're pregnant, and NOT when they're nursing! Tell your friend to start eating peanuts!"

So, this has sent me into a tailspin! It goes against what I thought I was doing right. I didn't eat peanuts after 16 wks gestation with my son or when I nursed him, and he still got a PA (but if someone offered me peanut-butter chocolate ice cream or Pad Thai, I would have a little---so I wasn't STRICTLY avoiding all pn products).

I don't know this doctor, but I do trust the reputation of Chicago's Children's Memorial Hosp. I have a message into the pediatric allergist's office (the OB has no conclusive thoughts on this at all) to see what he thinks. Back in April before I was pregnant, I asked about peanuts while pregnant/nursing and his response was "as of this moment, research suggests to avoid them while pregnant/nursing, but that could change as we find out more."

Thoughts??? Would you eat peanuts when you're pregnant? I don't even have peanut products in the house--although I wouldn't be so sad if I *had* to eat a Reese's PB Cup this Halloween somewhere else. Help! What have you guys heard?

A million thanks, Jen

On Oct 23, 2006

I had never heard of a peanut allergy when I was pregnant with my son and I ate peanut butter and jelly everyday almost. I formula fed and he is now 2 and has a PA/TNA.

On Oct 23, 2006

I ate peanuts and pb and did not avoid any nuts when pg and nursing with my PA/TNA son. Wish I had known. With my younger son (now 2), I strictly avoided any "traces" of nuts when pg and nursing. We have a nut-free household anyway, which includes "traces" but if I was out with a friend at the movies or dinner for example, I would avoid "traces". I treated myself like I was the one with the PA/TNA. Let's hope it helped. I know it doesn't guarantee anything, but it certainly helps.

On Oct 23, 2006

I really don't know what I would do now. Only 1 of my 3 is PA, and that took 18 years to happen. She (so far) is only ingestion reactive, so who knows if avoiding would have made any difference, or if the boys will develope PA - or any other FA's.

Glad I'm not in a position to have to make such a decision, it would not be easy. I THINK I would go for avoidance, or at least limited, but as I'm 1 for 3, I honestly don't know.

On Oct 23, 2006

Before my adult-onset PA, I happily eat celery and peanut butter throughout my pregnancy. My son, now 31, has no food allergies.

On Oct 23, 2006

For what it's worth--I ate peanut butter every day of my first pregnancy. He is PA/TNA, outgrew egg and milk allergy. My next pregnancy I ate no peanuts, tree nuts, or shellfish. He has no known allergies. My third pregnancy I followed the same restictions. She was milk allergic until 2, and egg allergic until 3. She never tested pos. for peanuts and has eaten them since we allowed her to try them at 4 (before preschool admission). You have to make the call.

On Oct 23, 2006

Hi there,

I am pregnant with baby #4. DD #1 is PA. I ate my fair share of peanuts with her. If somebody offered me PB ice cream, I did not just take a bite, I ate a whole bowl:-)

While pregnant with DD #2 I avoided any and all peanuts/tree nuts and shellfish. She is now 3 1/2. She RAST tested negative and has eaten peanuts (hidden in things as she is terrified of them). She had NO reaction whatsoever.

While pregnant with DS #1 I also avoided any and all peanuts/tree nuts and shellfish. Ryan has tested very low to peanuts and positive to tree nuts. However we are still avoiding all nuts with him. (due to sister's anaphylaxis and his RAST results).

So here I am with #4 and I am totally avoiding any nuts. I do not even eat may contains. However I do not eat those normally. We just are a big old peanut free family:-)

So I hope this at least gives you an idea of what somebody else is doing. Good luck with your pregnancy!!!!

On Oct 23, 2006

I don't know what to do either, I've heard the argument go both ways. There's no conclusive evidence that avoiding/eating peanuts during pregnancy causes anything, just hypotheses.

Some think that having some exposure to allergens in utero and as a young baby are good, which is where that doctor's idea is coming from.

Right now I'm not going to eat any peanuts or peanut butter because I have a toddler at home. I wouldn't want to risk him having exposure from it. I ate peanuts through my pregnancy and breastfed him while eating peanuts and he became allergic to peanuts.

For this one I'll avoid them completely, though until we found out he had PA I was sucking down peanut butter chocolate shakes.

I guess if I were you I'd lay off the peanut stuff for breastfeeding and not go out of your way to have peanuts if it makes you uncomfortable.

On Oct 23, 2006

Pregnancy #1 ate everything incl. peanuts.

Outcome #1 child allergic to egg, milk, peanut, treenuts. Outgrew egg, milk.

Pregnancy #2 avoided peanut, treenuts, shellfish.

Outcome #2 child allergic to egg, milk. Outgrew milk.

Just like everyone above, I'm not sure what any of this means, but here is the data if it helps you make your decision.

Cathy

------------------ Mom to 7 yr old PA/TNA daughter and 3 1/2 yr old son who is allergic to eggs.

[This message has been edited by Momcat (edited October 23, 2006).]

On Oct 23, 2006

I ate trail mix by the bag full when pregnant, and also when breastfeeding...DD age 3 allergic to peanuts.

Im now 17 weeks pregnant with baby #2. Im not eating any peanuts or treenuts at all (although I will admit that Im not super careful with may contains if not eating around my DD). I definitely wont when breastfeeding. Just like everyone else, Im horribly confused - I've heard of this theory also, but as usual there is no evidence to back any of it up.

But I do know the guilt I live with *if* I unknowingly did this, so even just for my own conscious Im not eating it.

But Im craving almonds SO bad.....

On Oct 23, 2006

(edited): I totally agree with you! I'm just afraid this "new" information is indicating that I should eat them in order to prevent another PA. It's all so confusing!

I did talk to our own pediatric allergist today, and he did offer a little bit more to go on. I know this is just ONE doctor's professional opinion here--so take it with a grain of salt. He said because my DS has a PA, it is recommended to avoid all peanut products in the third trimester and throughout breastfeeding. However, he also said that it doesn't mean the child won't get a FA, but it will probably postpone it. When I asked him to clarify, he basically said if you're genetically determined to get it, the allergy can be put "on hold" the early years by adhering to the previous suggestions, but that it will come out eventually. There is no true prevention. If that's the case, I guess it kinda eases the guilt of doing the "right" thing. I hope I got that right--had a crying toddler while I was on the phone with him.

I truly appreciate all of your thoughts and stories! This is so nerve-wrecking and confusing! I guess I'll just going to go with my instincts here and continue to avoid all peanuts--including may contains. It's pretty easy considering our house is entirely peanut-free, but man, AmyD, that peanut butter chocolate shake sure sounds good!! Maybe a year and half from now when I'm done breastfeeding.....

On Oct 23, 2006

i don't know who's right but i do know that i consumed massive amounts of peanut butter in my pregnancy with my first PA child. no one can convince me it doesn't have something to do with her allergy. however, my next child also has PA and i ate no peanuts or peanut products when pregnant with her. who knows????

On Oct 23, 2006

Hi Jen,

Here are my results:

#1 Eat PB and all nuts when pregnant and nursing. #1 child-allergic to peanuts

#2 Avoided peanuts, but ate tree nuts still. Acutally ate quite a few tree nuts-especially almonds and cashews. #2 child-allergic to tree nuts-especially cashews and almonds.

#3 Avoided all peanuts and tree nuts during pregnancy and nursing. #3 child-allegic to peanuts and tree nuts.

Go figure!

------------------ Stacie - Mother to: 10 yr. PA 8 yr. TNA 2.5 yr. PA&TNA

On Oct 24, 2006

During my first two pregnancies I ate pb. I did NOT take any penicillin due to that allergy being in my husbands family. I wasn't concerned that I would [i]cause[/i] an allergy -- I was concerned my unborn child would have a reaction and how would I know.

Both those kids are allergic to penicillin, but not to peanuts.

Third child was born after I developed my pa, so I didn't eat peanuts/nuts during pregnancy. (Also didn't take any penicillin.)

He is NOT allergic to peanuts. He has never had penicillin so we don't know about that. He IS allergic to insect venom -- which I'm pretty sure I didn't eat while pregnant. [img]http://uumor.pair.com/nutalle2/peanutallergy/eek.gif[/img]

On Oct 24, 2006

It is really hard to hear "new" information like that, if I could turn back the hands of time, I would choose not to consume peanut butter during pregnancy or nursing, my doctor (who has a PA child) believes that in utero exposure and during nursing causes exposure too early possibly causing the allergy ,the longer you put off exposure the better chance of avoiding the allergy. I would use more caution rather than trying new theory. Good luck.

[This message has been edited by maphiemom (edited October 24, 2006).]

On Oct 24, 2006

I think this is a very personal decision because it involves "mommy guilt" either way you go. However, I did want to post because there's a logical way to look at this if you believe what your doctor told you...

Either a) exposure to peanuts in utero can help prevent allergies by cueing the baby that these proteins are a normal part of the maternal environment and therefore shouldn't be feared, or b) exposure to peanuts in utero tells your baby to "be afraid of this allergen and react" and should be avoided.

If you believe "a", then you should eat peanuts. If you aren't sure between "a" and "b" but believe what your doctor said about an allergy being genetically-based, then you should probably eat peanuts. Why? Because if "a" is correct, you've prevented an allergy. If "b" is correct, then your child will be born sensitive and you've lost a couple of years of no reactions, but you really haven't lost anything because he or she would have been allergic anyway (and what baby eats peanut butter?).

It's only if you believe that exposure to peanuts in utero CAUSES an allergy that you should avoid them. The truth is...no one knows. I think doctors and nurses tell moms with PA children to avoid them because it gives the moms peace-of-mind that at least they didn't do something to actively [i]harm[/i] their child.

Personally, I don't think what we eat triggers allergies (other than that the allergic food has to be the right shape and molecular weight, and it has to be available in the cultural diet). A mother's immune system has developed over tens of thousands of years to help a child understand before it's born and during nursing what foods are "safe" and which are not. I believe there's a factor that causes allergies that's totally independent from the allergens themselves and somewhat independent from a predisposition to atopic disease.

Bottom line is that you're not going to be able to puzzle this out between now and then, so you're probably going to have to pick the expert you trust most and go with your gut. If you're find out you're wrong in 10 years - well, then you'll know what the topic of your child's therapy sessions will be in 20!

On Oct 24, 2006

Here's the thing though...in cultures where rice is a staple in the diet, kids become allergic to rice. Where it's predominently fish, there are fish allergies. The *allergen* isn't causing the allergy. Something else causes a child to be allergic (genetics, environment or both) and the allergenic food is just there, at the right place and time so to speak.

It would be nice to think we could prevent the food being there at all, but there are a lot of foods that fit the allergen profile and I don't think it's practical to think we could avoid them all. If you avoid peanuts, what about milk? What about soy? If you avoid them for a while and then your child starts eating solids, won't he/she be exposed to them then? Can you avoid all allergenic foods until the child's window "locks" and he can't become allergic? What about adult-onset allergies then? (I know my son developed new allergies after age 4, when his doctor said it was less likely.)

I understand that there's an emotional component to avoiding peanut butter, particularly if you're allergic, and if a mother feels that way about it, she should avoid it. I'm just questioning the science behind it.

[This message has been edited by BriandBrinasmom (edited October 24, 2006).]

On Oct 24, 2006

I would like to add that I am proof that exposure during pregnancy on occasion say 4 times in the whole gestation , and maybe while nursing once, certainly didn't help to prevent an allergy from occuring, I personally believe this is where I went wrong, the protocal was to avoid only when there is a family history , well my daughter is the only one in the family with peanut allergy. I always suggest to pregnant women that I know not to eat it during pregnancy or nursing just in case , it can't hurt , plus in my book and according to ALL my doctors not until after the age of 4 , unfortunately there are a lot of old books with old information out there in libraries etc. that do not have current information.

On Oct 24, 2006

Good article if you're interested:

[url="http://www.calgaryallergy.ca/Articles/English/whypeanutswhynow.html"]http://www.calgaryallergy.ca/Articles/English/whypeanutswhynow.html[/url]

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Even more controversial is the belief that pregnant mothers can sensitize their unborn babies. British studies on aborted fetal samples showed that from the second trimester onwards fetuses are capable of producing an allergic reaction. The researchers hypothesize that the antigens from the mother cross the placenta, or that the fetuses swallow IgE antibodies from the amniotic fluid. But this isn

On Oct 24, 2006

The research about IgE components possibly crossing the placental barrier is actually fairly new... The question is whether this is a good thing or a bad thing!

If a child has a genetic predisposition to an allergy, it's possible that having his mother's (presumably normal) IgE information for peanuts might help him or her. By getting this information in utero, it may mean that the baby's body already has the training to know what to do with peanuts (hopefully nothing!) the first time he or she sees them.

I recognize that it feels better to do something than nothing, so regardless of the supporting evidence, I understand why mothers would choose to restrict peanuts and/or other allergenic foods. It may also be why doctors might counsel them to do so (gives an anxious mother a focus). However, I don't think the evidence itself about this is conclusive. The studies I've seen have shown no different in the allergies of children at 7 years of age, regardless of whether their mothers avoided certain foods in utero.

I'm past having more kids myself (I think) so at this point this is just an intellectual issue for me. And yes, of course, every mother has to do what makes her most comfortable. Was just trying to answer the poster's question about why a nurse might tell her to eat peanuts during pregnancy. Will stop beating the horse now.

On Oct 24, 2006

Very good point about amniocentesis though... Doctors would never do an amnio just for this since there's a 1-2% possibilitly of miscarriage from the procedure, but if they saved the fluid from procedures done for other reasons, it would make an interesting study.

On Oct 25, 2006

I have often thought about this, as I have two pa daughters, waiting to find out about our 3rd child.

Yes, I did eat pb during pregnancy and breast feeding, but not tremendous amounts. I never had any allergies and neither did my husband. Go figure. My close friend ate pb during all three of her pregnancies and while breast feeding, gross amounts of it! There is family history of allergies, none of her children have pa allergies. Again, go figure. In some schools of thought she should have definately had a pa child.

I am of the belief that my children were going to have pa regardless of what I did. For some reason our genes together make pa children.

My thoughts on it. Cheers, Gilli

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