Am doing some studying for a self assessment exercise for PNP certification.
Thought you would be interested in 2 articles I have recently read.
NEngJM Vol 348:977-985 March 13, 2003 No.11.  Factors Associated with the
Development of Peanut Allergy in Childhood. "The apparent recent increase in
the prevalence of peanut allergy has been difficult to explain, although it
parallels an overall increase in allergic diseases of childhood. 5  We have
found that, in a cohort of preschool children, peanut allergy proved by
double-blind, placebo-controlled food challenge had important associations,
which persisted after adjustment of other factors, with a family history of
peanut allergy, consuption of soy by the infant, early onset of eczema,
other rashes with ozzing and crusting, and exposure to topical preparations
containing peanut oil.  The absence of an association with maternal
consumption of peanuts during pregnancy, combined with our inability to
detect specific IgE to peanuts in cord blood, argues against the occurance
of sensitization in utero.

Our data are not consistent with the hypothesis that sensitization occurs by
means of transmission of peanut allergens in breast milk.  The percentage of
mothers who breast-fed and the duration of breast-feeding were not
significantly associated with allergy to peanuts after regression analysis,
and the mothers of children with peanut allergy did not eat significantly
more peanuts during breast-feeding than the  mothers of the children in the
control groups.

Consumption of soy by the infants was independently associated with peanut
allergy and could not be explained as a dietary response to other atopic
conditions."

It goes on for another page, then says "We conclude that  a family history
of peanut allergy, the occurance of oozing, crusted skin rashes, topical use
of peanut oil based preparations and exposure to soy protein may be causal
factors in the development of peanut allergy.  Our peliminary data raise the
question of whether sensitization to food allergens occurs by the cutaneous
route rather than the oral route.  Confirmation of these associations in
future studies would allow us to determine whether new interventions could
decrease the rate of peanut allergy in the population."

What I got from this was: Choose your parents carefully :-);  b) do NOT
supplement with soy formula;  c)read the ingredients on topical creams !
Pat in SNJ

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