Got this from our media dept. Looks like it will be in JAMA next week
Mary Kay Smith, IBCLC
Mount Sinai Hospital Chicago IL
-----
EMBARGOED FOR RELEASE:  3 p.m. (CT) Tuesday, April 3, 2001
Media Advisory:  To contact Peter Vadas, M.D., Ph.D., call Nicole
Ireland
at
416/864-5349.

PEANUT ALLERGENS CAN BE PASSED FROM MOTHER TO BABY THROUGH BREAST MILK
May result in sensitization of at-risk infants

CHICAGO - Protein from peanuts ingested by lactating mothers is secreted

into breast milk, and exposure to peanut protein during breastfeeding
may
sensitize babies at risk of peanut allergy, according to an article in
the
April 4 issue of The Journal of the American Medical Association (JAMA).

Peter Vadas, M.D., Ph.D., of St. Michael's Hospital, University of
Toronto,
Ontario, and colleagues conducted a clinical investigation at two North
American hospitals from March 1999 to October 2000 to find out if
maternal
dietary peanut protein passes into breast milk during lactation.  The
authors tested breast milk samples from 23 healthy, lactating women aged
21
to 35 years.

According to background information cited in the article, peanut allergy
is
a significant public health problem.  Approximately 1 percent of British

and
U.S. preschool children are sensitized to peanuts. It starts early in
life,
is often associated with severe or life-threatening reactions, and
rarely
resolves.  Peanuts account for the majority of food-induced anaphylactic

fatalities.  Between 72 percent and 81 percent of individuals who have
reactions to peanuts do so on their first known exposure.  Since IgE (an

antibody) -mediated allergic reactions require prior exposure resulting
in
sensitization, earlier peanut exposure must have been hidden in most
cases.
Potential but unproven routes of hidden exposure include exposure in the

womb and exposure to peanuts transferred from maternal diet via breast
milk
during lactation.

The authors collected breast milk samples from women who avoided
ingesting
legumes (peanuts, beans, peas) for 24 hours, and fasted overnight.  The
women then consumed 50 grams (approximately one half cup) of dry roasted

peanuts.  Samples of breast milk were collected at 1, 2, 3, 4, 6, 8, and
12
hours after peanut ingestion.  The authors measured the presence in
breast
milk of total peanut protein and two major peanut allergens.

"Peanut protein was detected in 11 of 23 subjects.  It was detected in
10
subjects within two hours of ingestion and in one subject within six
hours,"
the authors write.

"The median [middle] peak peanut protein concentration in breast milk
was
200 nanograms per milliliter.  Both major peanut allergens [also] were
detected," they continue.

"Peanut proteins have long been suspected to be secreted but have never
been
identified in breast milk.  We now provide definitive evidence for
secretion
of peanut protein into breast milk of lactating women," the authors
assert.

"Peanut protein concentrations found in breast milk ranged from 120 to
430
nanograms per milliliter, comparable with the levels of
beta-lactoglobulin
[cow's milk allergen], ovalbumin [egg allergen], ovomucoid [egg
allergen],
and gliadin [dietary wheat allergen] detected in breast milk," they
continue.

The authors point out that several studies have documented an
epidemiologic
relationship between increased consumption of peanuts by pregnant and
breastfeeding mothers and the likelihood of allergic sensitization of
their
children.

"These studies, in conjunction with our data, suggest that transfer of
maternal dietary peanut protein to breast milk may predispose at-risk
children to occult sensitization," they conclude.
(JAMA.  2001; 285:1746-1748)

Editor's Note:  This work was supported by grants from Health Canada,
the
Peanut Foundation (non-profit organization of peanut producers, growers,

and
sellers), the Allergy, Asthma and Immunology Society of Ontario, and
Nestle
Canada.
#
For more information:  contact the JAMA/Archives Media Relations
Department
at 312/464-5374.

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