Abstract

Rationale The mechanism by which sensitization occurs in peanut allergy remains unclear. The United Kingdom Department of Health (DoH) recommendation of peanut avoidance by mothers during pregnancy and lactation is based on the hypothesis that peanut sensitization occurs as a consequence of exposure in utero or via breast milk. Methods A questionnaire based retrospective case controlled study comparing detailed maternal peanut consumption during pregnancy and lactation, between children who have peanut allergy and children who don't. Awareness of and compliance, where appropriate, with maternal peanut avoidance advice during pregnancy and lactation is also assessed. Results Average weekly maternal peanut consumption during pregnancy in the peanut allergic group (n=43) was 41.67g as compared to 32.90g in the normal controls (n=31). Average consumption during lactation in the peanut allergic group (n=37) was 23.40g as compared to 26.44g in the normal controls (n=28). These differences were not statistically significant (p=0.48, p=0.86). Mothers of children with peanut allergy were no less likely to have adhered to Department of Health guidelines, where relevant, compared to mothers from the control group regarding consumption during pregnancy and lactation. Conclusions The lack of statistically significant differences in both maternal peanut consumption and compliance with allergen avoidance guidance, does not support in utero or breast milk exposure as being the main routes of peanut sensitization. Further work is required to explore the role of other routes of exposure to peanut as a possible cause of sensitization in peanut allergy.

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