Breastfeeding and infant food allergy prevention: ‘Let the mamas eat’

December 27, 2022
4 minute read



Kaborek JL et al. How to advise breastfeeding mothers about diet. Presented: ACAAI Annual Scientific Conference. November 10-14, 2022.Louisville, Kentucky

Disclosure: Kabourek does not report related financial disclosures.

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LOUIVILLE, Kentucky — Breastfeeding mothers should be encouraged to eat from all food groups without excluding food allergens, says speaker at the American Annual Scientific Conference on Allergy, Asthma and Immunology. rice field.

There are no definitive data to show that breastfeeding reduces the incidence of food allergies in infants, but it does reduce the risk of certain cancers, postpartum haemorrhage, hypertension, type 2 diabetes in mothers, and sudden infant morbidity. There are still benefits for mother and baby, such as reduced risk. mortality syndrome, childhood obesity, and childhood gastrointestinal infections.

Breastfeeding mothers should be encouraged to eat from all food groups rather than eliminating food allergens. Source: Adobe Stock

“We all agree that breastfeeding is very nutritionally appropriate for infants and benefits both mother and child.” Jamie L. Kaborek, MS, RD, “Environmentally, it also helps reduce waste and pollution. It’s a renewable resource and it’s free.”

breastfeeding and food allergies

Guidance from the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of life. Complementary feeding can be introduced at this point and breastfeeding continued until 1 or 2 years of age.

Regarding diet and breastfeeding, in general, medical society guidelines do not recommend avoiding allergens during pregnancy or breastfeeding, Kavorek said, adding that he particularly likes the guidance from the European Society for Allergy and Clinical Immunology. .

“It is very short and concise and states that it is not justified to limit consumption of potentially allergenic foods during pregnancy or breastfeeding in order to prevent food allergies. Please do not do that.” she said.

Still, data on the impact of maternal diet during pregnancy and lactation on allergy prevention are limited, Kavorek said, but in general, a diet containing a variety of different foods and allergens is recommended. It is recommended to take

Kabourek referred to recently published data. Dr. Karina Venter, RD, Colleagues who developed a maternal dietary index that predicts the development of childhood allergic diseases. Specifically, women who ate diets high in fruits, vegetables, and yogurt, and reduced intake of fruit juices, fried foods, and low-fiber foods had a lower risk of allergic disease in infants.

“If you’ve heard Karina talk, she often says, ‘Let’s feed the baby,'” Kaborek said. “But I mean feed moms too. We want to emphasize the importance of a healthy diet in all aspects of pregnancy and breastfeeding.”

Conversely, if a breastfeeding mother is concerned that her infant is reacting to something in her breast milk, she should keep a food diary to keep track of what she ate, her baby’s symptoms, and their should be advised to follow how long the symptoms of Eating.

“This helps families identify foods, and it also helps medical professionals figure out what might be causing the problem,” Kabourek said.

Kabourek added that there are situations when mothers have to withhold food from their diets because of adverse events in their infants.

“If you have IgE symptoms, it’s generally more skin and gastrointestinal than respiratory,” she said. “Symptoms may be delayed, but gastrointestinal symptoms are usually present as well. Causative foods include milk, eggs, peanuts, tree nuts, and fish.”

Dietary management involves not only eliminating food triggers, but only one or two foods at a time should be eliminated and replaced with those of similar nutritional composition, Kabourek said. .

“We have to tell them to be tough on their exclusion,” she said. We offer an edible alternative.”

About a third of severe eczema in infants can be attributed to food allergies, especially if the onset is early, Kabourek said.

“I don’t think there’s anything wrong with fasting for two to four weeks, but you have to force yourself to be ready to reintroduce and take action if an IgE reaction occurs,” she said. Told.

Other dietary recommendations

While clinicians may not be able to make specific dietary recommendations during pregnancy to prevent food allergies in infants, there are still general dietary patterns that can be recommended to promote overall health. I have.

“I think we’re missing part of the boat. [talking to] pregnant mom,” she said. “There are probably other things they can do and we need to focus on their healthy diet and what that healthy diet is. It doesn’t hurt to say that refined grains aren’t good for you, just like eating whole fresh fruits and vegetables instead of juices when you’re hungry.”

Lactating women should be advised to increase their calorie intake by 300-500 calories per day and take supplements containing iodine, choline, folic acid, selenium and zinc.

There is not enough data to recommend specific prebiotics or probiotics. This is because it is difficult to pinpoint which bacterial strains are most beneficial. She added that it could be incorporated.

DHA and EHA are especially important to take in later in pregnancy because they help support the central nervous system and neurodevelopment, according to Kabourek. They are found in fatty fish such as salmon and flaxseed. .

Providing support

Breastfeeding can be complicated and every breastfeeding process is different, so clinicians should be prepared to support women who are breastfeeding.

“The women surveyed identified problems with breast milk supply, including developing mastitis or blocked ducts, infant latching or suckling problems, and postpartum depression,” she said. “This is exactly the time frame she needs to focus on to help her succeed.”

Overall, it is important to provide patient-centered guidance and identify family preferences when it comes to breastfeeding infants, Kabourek said.

“There is a balance point between reducing the medicalization of infant feeding and allowing families to enjoy the fun, discovery and joy of breastfeeding an infant because it is the most rewarding. It’s one of those experiences,” she said.


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