Government advice on peanut avoidance during pregnancy – is it followed correctly and what is the impact on sensitization?

Dean, Tara; Venter, Carina; Pereira, B.; Grundy, Jane; Clayton, C.B.; Higgins, Bernard

doi:10.1111/j.1365-277x.2007.00751.x

Cited by 45 publications

(35 citation statements)

References 12 publications

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“…Evidence from two studies (2,19) designed to evaluate the impact of the 1998 COT recommendations found that there appears to be confusion among the general public regarding the COT recommendations and that the advice has not been interpreted as intended. More than 60 % of women reported having reduced (rather than avoided) consumption of peanuts during pregnancy and lactation, including those not targeted by the COT recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…There was also no indication that the target group (women with a family history of allergy) were more likely to take up the advice. Of children who developed peanut sensitisation or allergy, a significant number (77 % sensitisation, 40 % allergy) of mothers reported that they reduced their intake or avoided peanuts (19) .…”

Section: Discussionmentioning

confidence: 99%

“…The remainder of the studies were either small case -control studies that often did not adjust for other factors or cross-sectional studies. Obtaining evidence of sensitisation for each child is problematic (often due to issues of consent) and response rates for skin prick tests were 21 % (2) and 62 % (19) for the cross-sectional studies. Most studies reported information on sensitisation to peanuts; there was little evidence on clinical peanut allergy.…”

Section: Discussionmentioning

confidence: 99%

“…Two cross-sectional studies were relevant to research question 4 (Table 3) (2,19) . One study utilised a birth cohort (658 children) from the Isle of Wight (19) ; subjects were initially recruited whilst mothers were pregnant.…”

Section: Question 2: Childhood Dietmentioning

confidence: 99%

“…One study utilised a birth cohort (658 children) from the Isle of Wight (19) ; subjects were initially recruited whilst mothers were pregnant. The infants were born between 1 September 2001 and 31 August 2002, 3 years after the COT recommendations were first issued.…”

Section: Question 2: Childhood Dietmentioning

confidence: 99%

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Peanut sensitisation and allergy: influence of early life exposure to peanuts

et al. 2010

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The aim of the present systematic review was to evaluate the influence of early life exposure (maternal and childhood) to peanuts and the subsequent development of sensitisation or allergy to peanuts during childhood. Studies were identified using electronic databases and bibliography searches. Studies that assessed the impact of non-avoidance compared with avoidance or reduced quantities of peanuts or peanut products on either sensitisation or allergy to peanuts, or both outcomes, were eligible. Six human studies were identified: two randomised controlled trials, two casecontrol studies and two cross-sectional studies. In addition, published animal and mechanistic studies, relevant to the question of whether early life exposure to peanuts affects the subsequent development of peanut sensitisation, were reviewed narratively. Overall, the evidence reviewed was heterogeneous, and was limited in quality, for example, through lack of adjustment for potentially confounding factors. The nature of the evidence has therefore hindered the development of definitive conclusions. The systematic review of human studies and narrative expert-led reviews of animal studies do not provide clear evidence to suggest that either maternal exposure, or early or delayed introduction of peanuts in the diets of children, has an impact upon subsequent development of sensitisation or allergy to peanuts. Results from some animal studies (and limited evidence from human subjects) suggest that the dose of peanuts is an important mediator of peanut sensitisation and tolerance; low doses tend to lead to sensitisation and higher doses tend to lead to tolerance.Peanut allergy: Diet: Prenatal exposure: Childhood exposure Onset of peanut allergy typically occurs in childhood, with 70-100 % (1) of peanut-allergic children being reported to react upon their first known dietary exposure to peanuts. Because IgE-mediated allergic reactions require prior exposure and immunological sensitisation to the allergen, this suggests that sensitisation has already been acquired, either in utero, or by unrecognised oral exposure or non-oral (cutaneous or respiratory) routes. As many as one in fiftyfive children in the UK may currently show evidence of an allergic reaction to peanuts (2) ; indeed, peanut allergy is the most common cause of severe allergic reaction to foods, causing 30 % of all cases of anaphylaxis outside hospital (3) . Data from the Isle of Wight UK Birth Cohort Study suggest a threefold rise in the prevalence of peanut sensitisation and allergy in children born between 1989-90 and 1994 -6 (4,5) . Recent data from children born in 2001 -2 show no further increases in the prevalence of peanut sensitisation and allergy (6) .In 1998 the UK Government issued precautionary advice to mothers whose children have a family history of allergic diseases, that they may wish to avoid peanut consumption during pregnancy and breast-feeding and avoid giving the child peanuts and peanut products until the child is 3 years of age (7) . The precautionary advice was...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Question 2: Childhood Dietmentioning

confidence: 99%

Section: Question 2: Childhood Dietmentioning

confidence: 99%

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Peanut sensitisation and allergy: influence of early life exposure to peanuts

et al. 2010

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Prospective Study of Peripregnancy Consumption of Peanuts or Tree Nuts by Mothers and the Risk of Peanut or Tree Nut Allergy in Their Offspring

et al. 2014

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Evolution of Guidelines on Peanut Allergy and Peanut Introduction in Infants

et al. 2017

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ood allergies constitute a major public health concern, and the prevalence of food allergies over the past decade has doubled. [1][2][3][4] Foods that most commonly cause allergic reactions include milk, eggs, peanuts, tree nuts, shellfish, fish, wheat, and soy. [2][3][4][5][6][7][8][9] Peanuts account for the most food-induced anaphylaxis and fatal reactions. 4,10,11 Furthermore, the reported prevalence of peanut allergy has nearly tripled in the last 10 years. 2,4,6,9 Peanut allergy occurs early in life, and based on published reports, 18.3% to 21.5% of children may outgrow their peanut allergy. 12,13 Thus, the persistence of peanut allergy is a concerning issue.Since the 1990s, studies have provided evidence that led to guidelines on the timing of peanut introduction. In 1999 and 2000, guidelines from the European Society for Pediatric Allergology and Clinical Immunology, the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), 14 and the American Academy of Pediatrics (AAP) Committee on Nutrition 15 suggested delaying the introduction of peanut. However, because of the increasing prevalence of peanut allergy, more studies, including the more recent Learning Early About Peanut Allergy (LEAP) 16 study and the Effect of Avoidance on Peanut Allergy After Early Peanut Consumption (LEAP-On) 17 study, report convincing evidence suggesting that early peanut introduction can help reduce the incidence of peanut allergy (Table ). These studies highlight the potential of an early peanut introduction to prevent peanut allergy and provide evidence to support recent recommendations on the timing of peanut introduction.This review discusses the earlier guidelines, highlights challenges to those guidelines, and reviews the new recommendations on early peanut introduction.

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Government advice on peanut avoidance during pregnancy – is it followed correctly and what is the impact on sensitization?

Abstract: The majority of mothers in this cohort avoided peanut consumption during pregnancy. It is likely that either the government advice is misunderstood by mothers, or that those who communicate the advice have not fully explained who it is targeted at.

Cited by 45 publications

References 12 publications

Peanut sensitisation and allergy: influence of early life exposure to peanuts

Peanut sensitisation and allergy: influence of early life exposure to peanuts

Prospective Study of Peripregnancy Consumption of Peanuts or Tree Nuts by Mothers and the Risk of Peanut or Tree Nut Allergy in Their Offspring

Evolution of Guidelines on Peanut Allergy and Peanut Introduction in Infants

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