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当提供母乳给具有免疫球蛋白 E 介导的食物过敏的儿童时,提供者的建议和产妇的做法。

Provider recommendations and maternal practices when providing breast milk to children with immunoglobulin E-mediated food allergy.

机构信息

Department of Allergy, Asthma, and Immunology, Scripps Health, San Diego, California.

Scripps Whittier Diabetes Institute, Scripps Health, San Diego, California.

出版信息

Ann Allergy Asthma Immunol. 2021 May;126(5):548-554.e1. doi: 10.1016/j.anai.2021.02.015. Epub 2021 Feb 24.

Abstract

BACKGROUND

There is limited research investigating maternal dietary practices and health care provider recommendations when providing breast milk (BM) to children with immunoglobulin (Ig) E-mediated food allergy.

OBJECTIVE

To explore health care provider recommendations and maternal practices when providing BM to children with IgE-mediated food allergy and to assess for possible IgE-mediated reactions to BM while the mother consumed the food to which her child has allergy.

METHODS

A web-based survey was distributed to breastfeeding (BF) mothers of children with IgE-mediated food allergies. Reported reactions to BM were scored by an allergist, provided only with the details of the possible reaction and not the suspect allergen or route of exposure, as to the likelihood that the reaction was IgE mediated.

RESULTS

A total of 133 mothers completed the survey. After food allergy diagnosis, 47.4% (n = 63) of the mothers reported that they were advised by their health care provider to continue BF without dietary restriction, 17.3% (n = 23) were advised to avoid eating the food(s) their child has allergy to while BF, and in 28.6% (n = 38), this concern was not addressed. A few of the mothers (12%, 16/133) reported that their child experienced an allergic reaction to BM. An allergist evaluated most of these reactions (75%, 12/16) as not likely IgE mediated.

CONCLUSION

This study exposed inconsistent recommendations for mothers providing BM to children with IgE-mediated food allergies. Most mothers were able to consume the food their child has allergy to without adverse sequelae. Standardized, evidence-based recommendations would enhance the well-being of these mother-infant dyads.

摘要

背景

目前针对提供母乳(BM)给患有免疫球蛋白(Ig)E 介导食物过敏的儿童时,产妇的饮食实践和卫生保健提供者建议的相关研究十分有限。

目的

探索为 IgE 介导食物过敏儿童提供 BM 时卫生保健提供者的建议和产妇的做法,并评估母亲食用其子女过敏食物时对 BM 产生 IgE 介导反应的可能性。

方法

通过网络向患有 IgE 介导食物过敏的母乳喂养(BF)儿童的母亲分发了一份调查问卷。由一位过敏症专家对报告的 BM 反应进行评分,仅根据可能反应的详细信息进行评分,而不提供可疑过敏原或暴露途径,以评估该反应是否为 IgE 介导。

结果

共有 133 位母亲完成了调查。在食物过敏诊断后,47.4%(n=63)的母亲报告称,她们的卫生保健提供者建议继续 BF,而无需饮食限制;17.3%(n=23)的母亲建议在 BF 期间避免食用子女过敏的食物;在 28.6%(n=38)的母亲中,这个问题没有得到解决。少数母亲(12%,16/133)报告称,她们的孩子对 BM 出现了过敏反应。过敏症专家评估了其中大多数反应(75%,12/16)不太可能是 IgE 介导的。

结论

本研究揭示了为 IgE 介导食物过敏儿童提供 BM 的母亲所接受的建议不一致。大多数母亲能够食用其子女过敏的食物而无不良后果。标准化、基于证据的建议将增强这些母婴二人组的幸福感。

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