PREGNANCY

Achoo: Nutrition During Pregnancy and Reducing Allergies in Children

By:  Lauren R. Crosby, MD, FAAP

June 20, 2019

Allergies are an overreaction of the immune system to substances called allergens that typically do not affect most people. Some common allergy triggers are environmental and can be difficult to avoid, including pollens, dust and animal dander. Other allergens, such as foods and medications, can be managed more directly.

Symptoms of allergies vary from individual to individual and may manifest as sneezing, runny nose, itching, hives, allergic conjunctivitis, eczema, wheezing, asthma or a life-threatening condition called anaphylaxis. Anaphylaxis is a severe allergic reaction with symptoms that include swelling of the lips and tongue, flushing, itching, vomiting and trouble breathing, and it must be treated immediately. The manifestations of an allergy may also change and evolve as a child gets older.

Eggs, peanuts and omega-3s

Unfortunately, the incidence of allergies has been on the rise over the past 50 years. The reasons for this are unknown, but millions of children suffer from various types of allergies. Wouldn’t it be great to be able to decrease the incidence of allergic disease? There is promising research underway to tackle the issue of how to reduce the incidence of allergies by incorporating omega-3 fatty acids into the diets of pregnant women.

In one study, pregnant women who took fish oil supplements (omega-3 polyunsaturated fatty acids), continuing for several months into breastfeeding, decreased the risk of their child experiencing an egg allergy by 31 percent and peanut allergy by 38 percent.1  A systematic review of other studies on this topic came to a similar conclusion as the study above, which demonstrated that taking omega-3 fatty acids during pregnancy can reduce the risk of egg and peanut allergy.2

It is not yet clear if the effect of fish oil on allergies is due to its anti-inflammatory properties or to some other yet unknown action. Since food allergies are on the rise and approximately 8 percent of children have them, being able to give a pregnant woman omega-3 fatty acids to help reduce the risk of food allergies could be an important step toward reducing the incidence of this potentially life-threatening condition.

Asthma

A prospective study from Copenhagen showed promise in reducing the prevalence of asthma in children born to mothers who received fish oil during the third trimester of pregnancy. The incidence of asthma in the group taking fish oil was 16.9 percent while the incidence in the control group was 23.7 percent.  There was also the added benefit of a reduction of lower respiratory tract infections.3

In my own pediatric practice, I work with patients that have allergies of one form or another. Most often parents bring their children in for environmental or food allergies. We discuss ways to identify what the allergen is, and how to treat symptoms to reduce the child’s discomfort and ways to prevent complications of allergies such as sinusitis, ear infections and asthma episodes. Often treatment requires the use of one or multiple medications, and though most parents would prefer not to use medications, they understand that at times there is no other option. Research is giving us hope that dietary supplements during pregnancy, such as DHA omega-3 fatty acid, may be helpful in reducing the frequency of childhood allergies.

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References

1.  Garcia-Larsen, V. et al: “Diet During Pregnancy and Infancy and Risk of Allergic or Autoimmune Disease: A systematic Review and Meta-analysis,” PLOS 15(2):e1002507.

2.  Vahdaninia, M. et al: “Omega-3 LCPUFA Supplementation during Pregnancy and Risk of Allergic Outcomes or Sensitization in Offspring: A Systematic Review and Meta-Analysis,” Annal Allergy Asthma Immunology 122(3):302-313 e2, Mar. 2019.

3.  Bisgaard, H. et al: “Fish Oil-Derived Fatty Acids in Pregnancy and Wheeze and Asthma in Offspring,” New England Journal of Medicine (NIJM) 375(36):2530-9, Dec. 29, 2016.

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