Food Allergy Prevention Begins at Birth for High Risk Families

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Nursing mothers can help prevent or delay food allergic reactions in high-risk infants through dietary modifications according to a recent report in the New England Journal of Medicine 1.

"Studies suggest that mothers from families with a history of allergies should refrain from eating peanuts through the duration of breast-feeding to avoid introducing peanut proteins to their offspring," said allergist-immunologist John M. James, M. D., Fort Collins, Colo. "A nursing mother should also avoid eating other foods that a baby is allergic to, which most commonly are eggs and cows' milk."

Approximately 6 percent of children may develop a food allergy by the age of two, and studies suggest infants with a family history of allergy may be two to three times more likely to develop an allergy. Exclusive breast-feeding of infants for the first 6 to 12 months of life is often recommended to prevent the development of milk or soy allergies during infancy.

Anne Muñoz-Furlong, founder and president of the Food Allergy & Anaphylaxis Network (FAAN), stresses that all new mothers, as well as mothers-to-be, should be informed about the seriousness of food allergies. "Prenatal education is important, so that by the time a mother begins nursing her newborn, she will be equipped with the strategies to mitigate the chances that her baby will develop a food allergy," she said.

"Children with severe food allergies require special precautions," said Barbara E. Magera, M.D., Chair, ACAAI Adverse Reactions to Foods Committee, Charleston, S.C. "Parents and all caregivers must be informed on how to prevent and manage a child's allergy reaction, including the administration of epinephrine (adrenaline).

"Parents should also make sure that epinephrine is immediately accessible in their child's classroom and that multiple school staff members are trained in its administration," Dr. Magera said.

Between 6-7 million Americans are estimated to have a food allergy, and this number is continuing to rise. Food-induced anaphylaxis is believed to cause about 30,000 trips to the emergency room annually. It is also estimated that between 150-200 people die each year, some of them children, because of severe allergic reactions to food.

"Currently, the only reliable therapy for food allergic reactions is restriction or complete elimination of the responsible food allergen and emergency management of reactions in case food allergen is accidentally ingested," Dr. James said.

Food allergy management tips from the ACAAI and FAAN include:

Carefully check all ingredient labels.

Learn other names of the food responsible for the allergy.

Exercise caution when eating out because restaurant staff is not always aware of specific menu ingredients or how food is prepared.

Be careful when eating food that is packaged in multi-packs with other foods. While one product may be considered "safe," there is a risk of cross-contamination because products may leak or become unwrapped.

Learn to recognize symptoms early and always be prepared to handle an allergic reaction.

Always carry epinephrine if a severe allergic reaction has occurred and wear a medical bracelet or necklace to quickly alert medical personnel or caregivers about food allergies.

Teach family and friends about the warning signs of an allergic reaction and how to manage it.

Obtain assistance from food-allergy cookbooks, patient support groups, such as the Food Allergy & Anaphylaxis Network, and registered dieticians.

Food Allergy Awareness Week (FAAW) is May 5 - 11. For more information about FAAW, or to request the "Preventing or Delaying the Onset of Food Allergies in Infants" brochure, contact FAAN at 800-929-4040

For a free copy of the brochure "About Food Allergies," call the American College of Allergy, Asthma and Immunology toll free number 800-842-7777

1 Sampson HA. Peanut allergy. N Engl J Med 2002;346:1294-1299.

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Food Allergy Prevention