Hi, All,
I have a client who mentioned to me, as an aside, that she was eating lots
of peanuts (for snacks).  She was not asking my opinion about eating
peanuts or expressing any concern about it.  But it made me worried, due to
the potential allergen exposure to her exclusively breastfed two month old.
 Since I have a nursing two year old who is dairy sensitive and reacts with
reflux when I take in too much dairy, I am very aware about the passage of
potential allergans...

Also Peanut (and Tree Nut) allergies are very very severe and on the rise
these days.  Also, in the US, one of the 'staple foods' that WIC gives to
pregnant and lactating women is peanut butter.  I did a quick search on
MedLine and came up with this:
Title
                      Food hypersensitivity and allergic disease: a
selective review.
                 Author
                      Chandra RK
                 Address
                      Department of Pediatrics, Memorial University of
Newfoundland, Canada.
                 Source
                      Am J Clin Nutr, 1997 Aug, 66:2, 526S-529S
                 Abstract
                      Food intolerance can be caused by immunologic,
pharmacologic, toxic,
                      infectious, idiosyncratic, metabolic, and
neuropsychologic processes. Food
                      allergy denotes an adverse reaction to food or food
additives in which an
                      underlying immunologic mechanism can be shown. Its
incidence in young
                      children is approximately 1.3% and among adults is
0.3%. Parental history
                      of atopy is a significant causal factor. In addition,
exposure to common
                      allergenic foods in infancy increases risk. For these
reasons, exclusive
                      breast-feeding and maternal avoidance of peanut, egg,
fish, and dairy
                      products during lactation has been recommended and
shown to reduce the
                      occurrence of food allergy. Wheat, egg, and fish
should not be introduced
                      until the infant is aged > 12 mo and peanut until the
age of 36 mo. These
                      measures and other environmental precautions can be
expected to reduce
                      the cumulative prevalence of allergy.

It seems pretty harsh to tell all nursing mothers to "avoid peanut, egg,
fish, and dairy products during lactation"... obviously we don't rountinely
teach this unless there is a known sensitivity in the baby or there is a
history of severe allergies in the family.

So what to do with this mother who just told me she is snacking on lots of
peanuts?  Again, she didn't ask me about it (not that it's ever stopped me
from sharing information before ;)  )  I hate to make breastfeeding about
restrictions and limitations.  I usually stress moderation overall.

But with the severe peanut allergy thing.  Is it the exposure duing
pregnancy and lactation that causes one to become sensitised and affected,
or does one have to have the tendency toward that particular allergy anyway?

Thanks for input,
NancyH
Nancy Holtzman RN BSN MOM
Great Beginnings New Mothers Groups
Boston MA
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