Many new mothers with infants want very much to breastfeed as it is the gold standard for early nutrition. What to do when you find out your young child has a food allergy, and you are breastfeeding? A new study in Annals of Allergy, Asthma and Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), found that more than 28% of the women were given no guidance on whether they could eat the same food their breastfeeding child was allergic to.
We found that guidance from healthcare practitioners for breastfeeding mothers in this situation was inconsistent," says Hannah Wangberg, MD, ACAAI member and lead author of the study. "Of the 133 mothers who completed the survey, 43% were advised to continue breastfeeding without dietary restriction and 17% were advised to avoid eating the food(s) their child was allergic to while breastfeeding. A minority of the mothers (12%) reported their child experienced an allergic reaction to breast milk."
Hannah Wangberg, MD, ACAAI Member and Study Lead Author
When mothers in the survey were asked if they had received conflicting advice from their healthcare providers on what they should or should not eat while breastfeeding their food allergic child, more than 30% said they had received conflicting advice. The study authors point out that the survey did not specifically ask whether the child's allergist or primary care provider gave the advice. The study also makes clear that no mothers were encouraged to stop breastfeeding entirely.
According to allergist Jay Lieberman, MD, chair of the ACAAI Food Allergy Committee, "There is no uniform guidance I'm aware of on this topic, which is perhaps one reason for the confusion. That's in part because there is not a lot of good data available. That said, there is little evidence that if a mother eats a food that the child is allergic to, that this will lead to a reaction in the child."
Dr. Lieberman says he tells breastfeeding mothers to continue breastfeeding and eating whatever they want. However, if they feel more comfortable avoiding the child's allergen, that's fine as well, but to continue breastfeeding is ideal.
For the 89% of mothers that continued to breastfeed after their child's food allergy diagnosis, 46% continued to eat the food their child was allergic to on a regular basis (greater than once per week) and did not alter how they provided breat milk to their child. An additional 25% continued to eat the food their child was allergic to on an infrequent basis (less than once per week) without altering how they provided breast milk to their child.
Wangberg, H., et al. (2021) Provider recommendations and maternal practices when providing breast milk to children with IgE-mediated food allergy. Annals of Allergy, Asthma and Immunology. doi.org/10.1016/j.anai.2021.02.015.