Tuesday, January 08, 2008

The Latest Food Allergy Stuff

Some of these articles have been piling up on me for a while.

First, an interesting insight into determining who is most likely to have an anaphylactic reaction. In a brand new article in the New England Journal of Medicine, researchers found that:

People who suffer anaphylaxis have higher levels of platelet-activating factor (PAF) than those who don't get such severe reactions.

As well as lower levels of an enzyme that breaks down PAF. This is a great discovery--it will be easier for docs to figure out if anaphylaxis is truly occurring (sometimes the symptoms are ambiguous) and figure out which people are most likely to have an anaphylactic reaction. Wouldn't it be great if you knew, based on a blood test, that you are Not Likely, Somewhat Likely, or Very Likely to have a full-blown anaphylactic reaction--before you have one? You could get that determination for yourself (or your kid) at the time of the diagnosis. This is really, really great news.

Let's see, what else? This news has been pretty widespread, but I think it's important to share again. A study was done in the UK that demonstrated that kids with a food allergy (egg or peanut, in this case) who were exposed to peanuts in their environment at home were more likely to develop peanut allergy than kids with a peanut-free home.

Interestingly, the link applied not to nuts eaten by children themselves, but to those eaten by family members. It is thought that oil and dust from nuts eaten by relatives enters a child's body through the skin or nose, disrupting its immune system and leading to an allergic reaction the first time the youngster eats peanuts itself. (emphasis added)

Obviously, more research needs to be (and probably is being) done, since the results appear to contradict some evidence that early exposure to peanuts prevents peanut allergy. The results of this study (about which I have no other information as to sampling, sample size, etc. so take with a grain of salt, please) do point to the importance of keeping the food-allergic person's environment as free of the allergen--and potentially other allergens--as possible.

Finally, more evidence that breast milk is best.

Breast-feeding helps prevent babies' allergies, but there's no good evidence for avoiding certain foods during pregnancy, using soy formula or delaying introduction of solid foods beyond six months.

That's interesting--that mom doesn't necessarily need to avoid allergens during pregnancy. This is probably another area where more research will be helpful. The very first thing I read about after Ryan's Big Peanut Kaboom was that it was all probably my fault because I didn't avoid peanuts during pregnancy and while he was nursing. Oh that was so hard to read, I can't explain. But don't let guilt plague you (I haven't for a long time):

"They say, 'I shouldn't have had milk in my coffee,"' said Dr. Scott Sicherer of the Mount Sinai School of Medicine's Jaffe Food Allergy Institute in New York. "I've been saying, 'We don't really have evidence that it causes a problem. Don't be on a guilt trip about it."' (emphasis added)

Now that I'm pregnant again, I still avoid peanuts, but mostly due to the known danger to my son. We just don't even have them in the house (and good thing, too, according to the research above!). I knowingly eat tree nuts only very occasionally (partly due to the risk to Ryan and Morgan), and fish and shellfish, too.

It's so difficult to know what the right thing to do is. I remember having multiple conversations with an acquaintance who was pregnant with her first child, about whether she should eat peanut products or not. My advice to her--as a food allergy mom, allergy sufferer, and incessant researcher, NOT as a doctor--was that if there weren't any allergies in her family, then to not worry about it.

I'd be interested in hearing from some of you food allergy moms out there--did you eat the allergens during pregnancy? Did you breastfeed? How did you handle subsequent pregnancies?

Oh! And finally, finally! If you are in the Atlanta area, please consider joining a new online support group called Support for Atlanta Families with Food Allergies. Lots of nice, friendly people, and good advice, too. I hope to attend the next Mom's Night Out.

Whew! That's it! Now that I've got all that out of my system, I can get on with other important things, such as abusing the Census Bureau and reading my Triple 8 book list and finding a new property manager for the cabin. I haven't mentioned that--I found out yesterday that our property management company is dropping us because our cabin is in a different county, the next one over! Sigh. Oh well, I was in Evaluation mode with them anyway.

And with that, I bid you, buh-bye! (For now.)


Leslea from allergyware.com said...

I'd still advise pregnant mothers to avoid peanuts just based on my own experience. We had no food allergies in our families until our first son. I avoided nuts ever after. Our next two sons were conceived and born in a nut-free home. No nut allergies.

I suppose someday they could develop the allergy, but chances go down the older you get, right?

Rational Jenn said...

I'm with you. If there are known food allergies, particularly to nuts, peanuts, fish or shellfish, I would definitely avoid. It's trickier for women who don't have a family history of food or other allergies. Some studies say avoidance is the best; others point toward the opposite. That's part of what's confusing for everyone (and something I wish the Food Allergy Conspiracy crowd could get through their heads!).

I avoided nuts and peanuts when I was pregnant with my daughter. We haven't had any testing done, so the jury is still out on her allergy status. I'm pg now and am avoiding. But it's so easy to do in part because we keep a nut/peanut-free home. And I agree--why go there if there's a significant risk?

Gabs said...

If we have another child, I'll be avoiding all nuts during pregnancy and i'll be breastfeeding ALOT longer this time. I guess the only saving grace is that if we do have another with an allergy, at least we'll know how to deal with it, right?

Rational Jenn said...

Gabs, welcome!

That's what I did with my second child. We nursed a LOT longer, exclusively for 6 months (really longer because she didn't get into solid food really for a while), I avoided nuts and tree nuts (which we do anyway). She is almost 3 and we will have her tested. It's possible she's allergic, I have no feel for it at this point.

But! I take comfort in the fact that I have done the best I could with the best medical advice that we have at this point in time. Nothing else I can do. I'm pregnant now, and following the same plan. We'll see!

By the way--if you'd like a reminder about the food allergy carnival, send me an email at rationalREMOVEjennATgmailDOTcom and I'll add you to my list.


Allergy Mom said...

I had no worries about allergies during my pregnancy, and didn't avoid any foods. Now I wonder about the coconut shrimp I ate 24 hours before my emergency c-section.

I tried to breastfeed exclusively, but didn't produce enough milk, so we supplemented with formula. That's how we discovered allergy #1 to cow's milk. As soon as my son was eating enough solids at about six months, I dropped the "special" formula and continued breastfeeding until he was a year old. At that point (and two allergies later) he started drinking soy milk, and I weaned him over several months.

Jenn, you are absolutely right, we can only do the best we can with the most reliable medical information available. I hope that the rest of your pregnancy goes smoothly!

Anonymous said...


I have a daughter with a nut allergy and I followed your link for the Atlanta support group. I registered there, but for about 3 days have been getting a message that says "your account is waiting for approval from a staff member," so I still can't actually get on the forum. I don't know if this is a technical glitch, or if they are really that slow?

Anyway, we are fairly new to the diagnosis and are doing pretty well with basic information, etc. (I'm a devoted label-reader anyway), but we are looking for an allergist that we like better, wondering about resources in the Atlanta area, etc., so the forum sounds perfect when we can get onto it.

Thanks! Jen

Rational Jenn said...

Hi Anon! Well, the local food allergy bulletin board went back to its original yahoo groups format. I wasn't aware of the yahoo group until recently. If you want the address of the yahoo group, email me at rationalREMOVEjennATgmailDOTcom and I'll give you more info.

I'm sorry to hear about your daughter's recent diagnosis. It can be difficult, but there is so much support out there. I love being able to bounce questions off of others who are in the same boat. So please email me when you get a chance.

And thanks for stopping by!

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Food allergy is an abnormal response to a food triggered by your body's immune system. A food allergy occurs when the body's immune system reacts to otherwise harmless substances in certain food.