As a vegetarian, I always make it a point to seek out food with high protein content like peanut butter and almonds. I’m even more aware of protein intake during my pregnancy. When a friend told me to be careful with nut products in my diet to not predispose the baby to an allergy, I turned to Chief of Allergy & Immunology Sami Bahna, MD, for answers. Nut allergies can be a very serious problem, and I wanted to get the facts straight.
I mistakenly thought that the only risk factor for a baby developing a nut allergy is a nut allergy in parents, but Dr. Bahna clarified that allergies don’t work like that. Kids inherit a tendency to be allergic, although not to any specific one item. Both my husband and I have allergies but nothing that Claritin or Allegra can’t handle (when I’m not pregnant; I rely on eye drops to ameliorate symptoms now).
Dr. Bahna said—for obvious reasons—well-controlled studies on pregnancy diet and a baby’s allergies are difficult to do. The very few studies out there show inconsistent results, which did not surprise him because allergy is a multifactor disease. Looking online for guidance also echoes that inconsistency—some sites or studies say eating nuts will actually protect your baby from developing an allergy, while others report it will up your risk.
Starting with the basics, Dr. Bahna explains that “the more the mother eats of a particular food, the more likely some of that food protein is to cross the placenta to the fetus or, once the baby is born, into the breast milk.” So, babies can be born already sensitized to certain foods, and exclusively breastfed infants can show allergies to foods before they have even eaten solids.
What if the baby is at higher risk for a food allergy due to his or her parents or a sibling already having one? According to Dr. Bahna, the conservative advice is:
-The mother should avoid or minimize the most common allergenic foods (peanuts, tree nuts, egg, fish, milk) from her diet during pregnancy and lactation. Calcium and vitamin supplements are beneficial if milk is eliminated.
-Supplementing breast milk or formula with solids can start at 4 to 6 months, gradually with simple baby vegetables, fruits and cereals. According to experts’ opinion, regular milk may be introduced at 1 year, eggs at 2 years, peanuts at 3 years, fish at 4 years and shellfish at 5 years.
-If a milk supplement is needed during early infancy, certain hypoallergenic formulas are available.
Based on the known research and the risk of our child, I plan to keep nuts in my diet for their folate and protein benefits. I may think twice though before developing a PB&J a day routine (for many reasons) since I do have some allergies.