1.  Why is it important to identify if you have or believe you may have food allergies during pregnancy?

This is a time of complete change for your body and the development of a new human being!  Food allergies may be present and it is vital that you are proactive in dealing with your food allergies.  If you have been diagnosed with a food allergy, you should avoid all foods/ body products, cleaning, pet and supplements. Same with intolerance and sensitivities. 

It is best to be aware of what you eat and write down any your symptoms. You can use the standard paper and pen or use an App to record what you eat, when and any reactions.  Especially helpful to show your medical team.

An anaphylactic reaction not only affects you, but can be life-threatening to your baby in utero. Have your auto-injectors of epinephrine available at all times.  Tell your OB-GYN and medical team about your food allergies so they can best support you and your baby. 

The Top 8 allergens are milk, egg, peanut, tree nuts, fish, shellfish, wheat and soy. Sesame will soon be the 9^th allergen.

It is important to understand the differences between a food intolerance and a food allergy especially during pregnancy.

A food intolerance normally resides in the digestive system and is due to a lack of certain enzymes to properly break down a food such as milk. Symptoms are bloating, diarrhea, stomach cramps, gas and nausea. Many people can take enzymes such as a Lactaid to provide the proper enzymes to break down the lactose in the dairy product they have eaten. This is a food reaction that can be uncomfortable but it is not life threatening.

A food allergy is your immune systems’ response to a protein in a food that it misidentifies as an invader and signals the release of IgE antibodies into your system. The IgE antibodies trigger the release of histamines into your body which can cause swelling of mouth, tongue, hives, rashes, vomiting, feeling faint, passing out and trouble breathing. The allergic reactions can range from mild to most severe life- threatening reaction called anaphylaxis.

If you suspect you may have food allergies, it is important to see an allergist and have testingwhich is primarily done through skin prick testing and a blood test.  Once diagnosed with a food allergy always have your emergency medications (2 auto injectors of epinephrine) and emergency plan in place at all times. Speak with your allergist before making any food challenges err on the side of safety.  I want to emphasize that food allergies are a real medical condition that can cause life-threating reactions.  Do not hesitate to seek medical evaluation if you believe you have a food allergy.

2. How to approach to eating for myself and my unborn child of diet

My Personal opinion is to support all systems in your body during pregnancy for optimal results.  I believe this is even more important during this time of COVID-19.  Many systems are interrelated and are important for you and your development of your baby.

During pregnancy, how you process your food is very important.Your gut biome includes many enzymes, microbes, bacteria within your digestive system.  Your gut affects your brain which is command central for all systems. This reinforces how important a healthy digestive system is to your overall health

Strict avoidance of your specific food allergens is the best option (and only in my mind) to avoid any reactions including the most sever being an anaphylactic reaction which can be life threatening. 

Try to stick to simple recipes with pure ingredients with the least amount of chemicals and processing. This will help support your body and sanity!  If you can’t find a vegetable or fruit in your produce section try a frozen version.  Meal planning is a great tool for those with food allergies and it is more time upfront but saves you time and stress during the week. 

If you do not have specific food allergies, it is recommended that you eat a well-balanced and varied diet for the best benefits for you and your baby.  A varied diet with whole foods and keeping it simple is best for both mom and baby. Everyone has their own complex network and it best to work with a nutritionist on the basics but also deeper dive to address key nutrients and vitamins levels in your body.  You may need to alter your diet or add in supplements as recommended by your medical team.

3. Can I do anything to prevent my unborn child from having food allergies?

No conclusive studies on pregnant women and unborn children have been done at this time.  Some studies have examined early introduction of peanut and egg allergens in high risk babies.

In a reversal of earlier policy, the American Academy of Pediatrics is now recommending that potential allergens be introduced to your infant earlier rather than later. The AAP now advises that, in the case of infants who are at high risk of allergies, peanuts should be introduced between 4-6 months. Infants at highest risk of developing peanut allergies are those with eczema or egg allergies or both.

It was originally believed that introducing your baby to the foods when is older might make any reactions more manageable. There have not been additional studies published yet for the additional categories of food allergens.

With this new information and change in guidelines, many women are unsure of which path to take in with early exposure or no exposure. Pregnancy is a constantly changing state for your body and I personally would err on eating foods I know are safe especially during COVID.   This is highly personal choice and know that whichever way you go you are doing so with the best intentions in mind.  

If you have food allergies then strict avoidance or them is the only safe course of action. 

Remember you know your body best and from the moment you are pregnant you are your baby’s’ number one advocate.  

4. How do I make the decision on which allergens to avoid or not avoid during my pregnancy and the 4^th trimester (breastfeeding/formula)?

• DECISION TREE: Everyone is unique and these questions are a helpful tool to assist you in determining how to identify potential foods that may be having a negative impact on your health.   

1. Are you concerned or questioning whether or not to eat or have products in your household with a common ingredient that may pose a risk to you or someone in your household?

YES– GO TO QUESTION #2

NO- STOP HERE.  Keep vigilant for any signs of potential reactions to foods and keep a healthy and varied diet. Even if you have no symptoms, keeping a food journal will provide valuable information as a base line to know which foods are safe for you.

2. Do you have a diagnosed food allergy?

YES– STOP HERE. Avoid all food and personal/pet products that may contain your allergen (s), have an emergency plan and 2 auto-injectors of epinephrine available at all times.

NO – GO TO QUESTION #3

3. Are you having any negative symptoms after you eat certain foods? Such as (can be up to 24 hours later) of hives, rashes, diarrhea, bloating, stomach ache, headaches, aches or fatigue?

YES– STOP HERE:  Write down each one and avoid eating or using these products.  You may need to supplement due to lack of vitamins/ nutrients if you are missing a whole category of food.   You may be able to re-evaluate after a couple of months of your system being clean of your potential sensitivities/intolerances.  If you have any swelling, trouble breathing, fainting or any severe symptom seek medical evaluation and avoid the trigger food(s).

NO– STOP HERE: If you are not experiencing any negative symptoms then continue on your varied and healthy diet.

Note: If you have an allergy make sure the food is either not present in the home or you take special measures to avoid cross contamination. Such measures include, cleaning surfaces, using separate utensils including pots and pans, labeling, ingredient reading, and of course hand washing.

5. Final Tips

•  Not Just Food: If you are having an adverse reaction to a particular food or chemical make sure to check not only your food but also your household cleaning products, medications, supplements, body products and pet products to make sure your entire household is free from the ingredient(s) you are trying to avoid.
• Hypoallergenic: This term is found on a lot of pregnancy and baby products and it can cause some confusion. Initially, I thought it meant the product was 100% allergen free. It does not mean it is free from the top 8 allergens and you may also have reactions outside of the classic 8 allergens.  You need to be your own case detective and read each and read the label each time to confirm it is safe for you and your baby.   
• Emotional Well Being, stress affects the whole body.  We are in stressful times so take care to make time for yourself to relax, move, sleep, keep connected to others, eat well   stay hydrated and laugh. Journaling, talking to friends or seeking out professional support are all valuable resources to help maintain your emotional well-being.  There are a lot of changes going on in your body and hormones so be gentle with yourself. 
• It all comes down to you as an individual and your household.  You want to have a safe, supportive and peaceful state.  Studies, statistics and articles are in abundance.  So many things keep changing year to year.  There are no absolute answers at this point to eliminate food allergies.  Arm yourself with knowledge, use your resources and be careful of fear and guilt.  You have to make decisions for yourself and your family with the information that is currently available. Then go with what feels best at this time.  As you make your decisions or new changes occur, update your medical team to keep everyone current. A united front is important from both a medical and emotional standpoint.  Feel proud as you empower yourself with knowledge and move through your pregnancy.