Food Allergies and PregnancyKristen J. Gough
For Stacia Broadhead, drinking a glass of milk would be lethal. “Whenever I eat something with even a little bit of milk in it, like bread, my mouth tingles,” explains the Houston mother of three. “I know to stop eating whatever it is or else my throat tightens and it becomes difficult to breathe.” Broadhead has been allergic to milk since infancy. Her allergies seemed to subside for a time in her early twenties. Yet with her first pregnancy she says her symptoms came back stronger, and ingesting even the slightest amount of milk gave her the familiar tingle.
Over the past ten years, there has been an explosion of research and information as food allergies have gained recognition—and acceptance—in the medical world. Still, there is little research on how pregnancy may affect a woman’s allergies. Most women with food allergies like Broadhead tend to self-regulate their symptoms; however, women with food allergies, or those who suspect that they may have an allergy should take extra precautions during pregnancy to ensure the safety of their own health—and their babies’.
What Are Food Allergies?
According to the Food Allergy and Anaphylaxis Network, 11 million Americans or four percent of the general population suffer from true food allergies. Put simply, a food allergy is when a person’s immune system falsely considers an otherwise innocuous substance, like food, to be harmful. The body seeks to defend itself by creating antibodies to combat the supposed invader. These antibodies, called immunoglobulin E or IgE, act as scouts and messengers to the body’s immune defenses. Once the antibodies have been created, the body will be able to identify the food culprit and mount an attack. For this reason, most allergy sufferers will not experience a reaction the first time they eat a certain food, perhaps not even the second, but as their bodies build up more antibodies to the food, reactions will likely occur.
Food allergy symptoms include a host of inflammatory ills such as a runny nose, itchy throat, tingling sensations on the tongue, lips, or throat. Other symptoms include skin reactions like hives, rashes, eczema, or abdominal problems including cramps, diarrhea, or even vomiting. “Most people think it’s some rare or unusual food in a person’s diet that causes the reaction,” advises Dr. Carol Fenster, PhD, President and founder of the Savory Palate, and author of Wheat-Free Recipes and Menus “Usually it’s the foods you eat the most are the ones that cause the problem.”
It is important to note that food intolerances can cause problems similar to food allergies. Yet food intolerances differ because the body’s immune system is not involved in the reaction to the food. Lactose intolerance is an example of food intolerance where the body does not produce certain enzymes necessary to digest the food properly. Although food intolerances can make a person extremely uncomfortable, they are not life threatening. “Technically, people who suffer from food intolerances far outweigh those who suffer from food allergies,” says Dr. Fenster.
Causes and Effects
“Any food can potentially cause adverse reactions in your body,” says Dr. James Pollowitz an allergist in Scarsdale, New York, and the president of that state’s section of the American Academy of Allergy, Asthma & Immunology (AAAAI). Yet in order to be a “food allergy” according to most physicians’ definition, the reaction must involve the immune system. Food allergy sufferers can tolerate different “doses” of the food. Broadhead can tolerate a little milk in certain foods, while some sufferers experience symptoms with the slightest contact; for instance if one person touches the food culprit and then touches the food allergy sufferer. (The most common food allergens include milk, eggs, wheat, soy, peanut, tree nuts, fish, and shellfish.)
Many women worry that their food allergies may hurt their unborn children, but in most cases, there is nothing to be concerned about. “Normally, an unborn baby will not be affected by food allergies unless the woman has a severe reaction,” says Dr. Dan Atkins, Director of Ambulatory Pediatrics at National Jewish Medical and Research Center. For instance, if a woman experiences a reaction to food and goes into anaphylactic shock or has a complete body shutdown, blood flow will be decreased to the baby. If the reaction isn’t stopped, both the woman and her unborn baby will die.
“I advise all my patients to carry their Epi-Pen in case of a problem, and yet I’m surprised how many don’t,” reports Dr. Atkins. Epi-Pen, or an injector for Epinephrine is a common medication used to control a severe allergic reaction. Broadhead admits she doesn’t like to carry hers. For milder symptoms, antihistamines such as Benadryl may be appropriate. But Dr. Atkins cautions that women consult with their obstetrician or midwife before taking any medication—especially over-the-counter ones that may cause other problems such as extreme drowsiness or dizziness.
Make sure to discuss any food allergy with your obstetrician or midwife. If there are certain foods that you’re avoiding, you may need additional vitamin supplements to provide adequate nutrition for you and your growing baby. On the advice of her doctor, Broadhead took calcium supplements along with her prenatal vitamins.
Do You Have a Food Allergy?
If you suspect you may have a food allergy or intolerance, the first thing you should do is start keeping a food diary. Both Dr. Fenster and Dr. Atkins believe that keeping a food diary not only helps you track which foods are causing reactions, but it also gives your doctor the necessary information to suggest treatment. “Write down what food you ate and how you felt immediately afterwards, then five minutes, and then a couple of hours later,” says Dr. Fenster. Some reactions can occur several hours after you’ve eaten a culprit food.
Don’t be afraid to get a second opinion if you feel your doctor doesn’t understand your concerns. “There’s no drug to treat food allergies, no pharmacy to visit for medication,” cautions Dr. Fenster. “So some doctors are still reluctant to diagnosis food allergies or even recognize them.” Ask friends or check the information board at your local health food store for other people with food allergies. They might be able to recommend a doctor, or, more appropriately according to Dr. Fenster, a nutritionist to help you manage your food allergies.
If you think you may have a food allergy, your doctor might suggest a skin-prick test, where a small amount of the food allergen is injected under the skin to detect a reaction. A blood test may be another route of testing. In this case, a sample is sent to a laboratory where tests are done to determine whether the blood contains IgE antibodies to suspect foods. Neither test poses any risk to your baby. Allergists may also suggest an elimination diet where the patient cuts out certain foods and then reintroduces them to gauge reactions. Dr. Atkins, however, advises against food allergy testing during pregnancy unless a woman has a severe reaction to a certain food.
Dealing with Food Allergies
No one knows for sure if food allergies worsen during pregnancy. Some doctors believe that allergy symptoms lessen overall during pregnancy because a woman’s immune system is suppressed so that her body doesn’t reject her unborn baby. There have been no specific studies to suggest whether this is valid or not. Most food allergy sufferers learn how to manage their symptoms on their own so they don’t report problems—good, bad, or otherwise—to their obstetrician. Broadhead says that she noticed her food allergy symptoms increase during pregnancy. Moreover, she had adverse reactions to eggs while she was nursing. “I didn’t say anything to my doctor, though,” admits Broadhead. “He’d probably think I was crazy.”
So, how should you treat food allergies while you’re expecting? Strict avoidance. If you know that you are allergic to certain foods, make sure to avoid them. Dr. Fenster advises constant vigilance during pregnancy to avoid problems. “Be wary of restaurants and ask about ingredients,” she adds. Read food labels carefully. Dr. Fenster admits that you may have cravings—especially for that forbidden food. Make meals ahead of time and freeze them so that when the cravings hit you have something to eat that will satisfy your hunger and won’t cause an allergic reaction.
If you have any concerns about foods that may be giving you problems—severe or slight—talk to your obstetrician or midwife. You may wish to have them recommend a nutritionist to help you evaluate your diet. It’s never a bad idea to review your diet, especially during your pregnancy to ensure that both you and your baby are getting all of the nutrients you both need to stay healthy.