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

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

OBJECTIVE: This study explored health care provider recommendations and maternal practices when providing BM to children with IgE-mediated food allergy. We also assessed for possible IgE-mediated reactions to BM while the mother consumed the food to which her child was allergic.

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 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: 133 mothers completed the survey. After food allergy diagnosis, 43.4% ( n = 63) of mothers reported 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 was allergic to while BF, and in 28.6% ( n = 38) this concern was not addressed. A minority of mothers (12%, n = 16/133) reported their child experienced an allergic reaction to BM. An allergist evaluated most of these reactions (75%, n = 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 was allergic to without adverse sequelae. Standardized, evidence-based recommendations would enhance the well-being of these mother/infant dyads.