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Peanuts during pregnancy, breastfeeding and early childhood

In August 2009, the Government revised its advice to consumers about eating peanuts during pregnancy, breastfeeding and the first few years of life, in relation to the risk of developing peanut allergy in childhood. (FSA 2009)

The change in advice followed a major review of the scientific evidence that showed there is no clear evidence that eating or not eating peanuts (or foods containing peanuts) during pregnancy, breastfeeding or early childhood has any effect on the chances of a child developing a peanut allergy. Therefore, the Government's previous advice that women may wish to avoid peanuts during pregnancy and breastfeeding and not introduce peanuts into their child's diet before three years of age, if their child has a family history of allergy, was no longer appropriate. (FSA 2009)

Advice on eating peanuts during pregnancy

  • If you would like to eat peanuts or foods containing peanuts (such as peanut butter) during pregnancy, you can choose to do so as part of a healthy balanced diet, unless you yourself are allergic to them or unless your health professional advises you not to.
  • You may have heard that some women, in the past, have chosen not to eat peanuts when they are pregnant. This is because the Government previously advised women that they may wish to avoid eating peanuts during pregnancy if there was a history of allergy in their child's immediate family (such as asthma, eczema, hayfever, food allergy or other types of allergy). But this advice has now been changed because the latest research has shown that there is no clear evidence to say that eating or not eating peanuts during pregnancy affects the chances of your baby developing a peanut allergy.
  • If you have any questions or concerns, you should discuss these with your GP, midwife, health visitor or other health professional.
  • If you choose to avoid eating peanuts or foods containing peanuts during pregnancy, you can do so by reading the ingredients list on food labels, where peanut must be declared by law if it is an ingredient. (FSA 2009)

For more information, please visit:

http://www.food.gov.uk/safereating/allergyintol/peanutspregnancy

Pregnant women who are concerned about swine flu should take the usual precautions as they would to protect against ordinary influenza as recommended by the Royal College of Obstetricians and Gynaecologists.

Swine Influenza Type A (H1N1) is a respiratory disease that can be caught through contact with an infected person. As this is a new strain of the virus, human immunity will be low. The symptoms are:

  • Fever
  • Cough
  • Shortness of breath And a combination of one or some of these:
  • Sneezing
  • Runny nose
  • Headaches
  • Tiredness
  • Aching muscles
  • Loss of appetite

Pregnant women who are concerned about swine flu should take the usual precautions as they would to protect against ordinary influenza. Ensuring good personal hygiene is key to preventing the spread of the disease.

The Royal College of Obstetricians and Gynaecologists (RCOG) recommends the following measures to prevent contracting swine influenza:

  • Cover your nose and mouth when coughing or sneezing and use a tissue
  • Dispose of used tissues promptly and carefully
  • Wash your hands with soap and water to reduce the spread of the virus
  • Clean hard surfaces like door handles using a normal cleaning product
  • Make sure your children follow this advice
  • Stay at home if you have symptoms

Should women require more information if they think they have been exposed to the flu, they should refer to the recommended websites (see notes below) and then speak to their GPs and midwives. If they have flu-like symptoms, pregnant women should seek medical attention. The RCOG will continue to work with the Department of Health so that maternity services are prepared to deal with an influenza pandemic. Current work includes modelling to establish the likely spread of the disease so that appropriate flu planning takes place. Contingencies exist so that maternity services will be staffed during a pandemic. Women should note that the NHS has stockpiles of the antiviral Relenza (Zanamivir) specifically for pregnancy that can be mobilised if required.

For more information, please visit:

DirectGov - http://www.direct.gov.uk/en/Swineflu/DG_177831

Department of Health - http://www.dh.gov.uk/en/index.htm

The World Health Organization (WHO) has stated that it is safe to consume well-cooked pork and pork-based products. The Food Standards Agency has published similar advice - http://www.food.gov.uk/safereating/animaldiseases/swine/.

The Foreign and Commonwealth Office has advised against travelling to affected countries. More information is available here - http://www.fco.gov.uk/en/travelling-and-living-overseas/swine-flu.

New American Guidelines for weight gain in pregnancy 2 June 2009

The IOM (Institute of Medicine) in America has produced new guidelines for weight gain in pregnancy. These guidelines have a new category for obese women. The categories are based on the BMI of the mother before pregnancy, and give a weight gain range to take into account age, ethnicity and height. These guidelines should be used in conjunction with good clinical judgement and discussion with each individual mother.

It should be remembered that these are American guidelines and have not been adopted in the UK. For more information see http://www.iom.edu/3788/48191/68004.aspx

Folic Acid and Congenital Heart Defects 19 May 2009

A new study in Canada has investigated folic acid and it's role in preventing congenital heart defects. In 1998 all grain products like bread and pasta had to be fortified with folic acid by law in Canada. The research compared the rates of severe congential heart defects before and after the fortification programme began.

The results showed that rates of congenital heart defects were lower after the fortification programme began. However the study did have some limitations. Here is a link the the NHS Choices story for more information about the study and it's limitations: www.nhs.uk/news/2009/05May/Pages/FolicAcidBabyHeartProblems.aspx

Treatment of severe nausea and vomiting in pregnancy 8th May 2009

A hospital in America has introduced a new protocol to treat severe nausea and vomiting which appears to be more effective in improving symptoms quickly, and provides a safer option. The findings, which are good news for mums and babies, are published in the European Journal of Obstetrics and Gynecology and Reproductive Biology.

The research evaluated 229 pregnant women who were admitted to hospital and treated for severe nausea and vomiting. The scientists compared use of the standard drug droperidol versus the administration of a newer medication called metoclopramide.

They found that metoclopramide worked faster to reduce the symptoms of nausea and vomiting than droperidol. Importantly, they found no evidence that either of these medications increased the birth defect rate compared to women who received no medication.

Vitamin E supplementation 14th April 2009

New research by scientists in the Netherlands has found that vitamin E supplements taken during pregnancy can increase the risk of heart defects in babies.

Scientists in Holland examined possible associations between congenital heart defects (CHDs) and maternal intake of vitamin E and retinol - retinol is the animal form of vitamin A for which very high intakes have previously been associated with birth defects.

Vitamin E is found naturally in numerous foods including nuts, avocado and olive oil and is important to human health – excess vitamin A (retinol) has already been linked to causing harm to the development of the foetus and for this reason, consumption above 700 micrograms per day from supplements during pregnancy is not advised. No such recommendations currently exist regarding safe vitamin E levels during pregnancy but pregnant women need not be concerned by vitamin E in foods as long as they eat a healthy, balanced diet, but should avoid taking vitamin E supplements.

The study involved Dutch mothers, 276 of whom had given birth to a child with a congenital heart defect (the case group) and 324 of whom had given birth to a healthy child (the control group). There are a number of limitations to this study i.e. it was a case-control study that the mothers' diets were assessed when their children were already 16 months old, which may not reflect diet around the time of conception and birth. It is clear say the experts that further research is needed into the important question of whether high amounts of vitamin E in the diet during pregnancy increase the risk of congenital heart defects in newborns. The research is published in the British Journal of Obstetrics and Gynaecology.

The 'Health in Pregnancy ' Grant 9th April 2009

The Department of Health have announced a new non-means tested grant for pregnant women. The £190 payment 'to help with the costs of a healthy lifestyle, including diet, in the later stages of pregnancy' will be available to pregnant women from the 25th week of pregnancy. The payment will be linked to the requirement for pregnant women to seek health advice from a health professional about their diet and lifestyle.

Have a look around our site for ideas on how to get your baby off to the best start.

If you are pregnant or have a child under four years old, and you receive Income Support, income-based Jobseekers Allowance or Child Tax Credit without Working Tax Credit and have a family income of less than £15,575, you could also get Healthy Start vouchers to buy milk, fresh fruit, vegetables and infant formula milk. You can also get free vitamin supplements. To find out more and see if you qualify, visit the Healthy Start website.

Eating During Labour 26th March 2009

Since the 1940s, women have been advised not to eat during labour to reduce the risk of complications if Caesarean is required, principally due to the risk of breathing food back into the lungs while under a general anaesthetic.

A new research study from the UK reported in this week's British Medical Journal, that a light diet during labour has no effect on labour and birth outcomes, and neither does it increase the risk of vomiting.

This unique study randomised 2,426 women in labour with their first baby to either eating a light diet during labour, or to drink water only. It found no significant difference between the groups in any of the outcomes assessed, including type of delivery, labour duration, use of analgesia, risk of vomiting, and newborn responsiveness or need for special care.

Yet another big media circus around alcohol and pregnancy! 22nd January 2009

   These recent stories are based on a study that questioned 4,700 new mothers on their drinking habits in pregnancy, and looked for links to prematurity and low birth weight. While the study did suggest drinking alcohol increased risk of prematurity, the links were weakened after taking into account smoking and other known medical and pregnancy-related risk factors.

Current recommendations have not changed i.e. women should aim to avoid drinking during the first three months of pregnancy. Beyond that, they should drink no more than one or two units once or twice a week, and they should avoid binge drinking. For more information See our alcohol section, under lifestyle pages. NHS choices website

Peanut advice revised. 12th December 2008

The Food Standards Agency will shortly recommend to the Government that advice on avoiding peanuts during pregnancy, breastfeeding and early life, where there is a family history of allergy, is revised in light of new evidence. See Food Standards Agency

Pregnant women advised to reduce caffeine intake to 200mg a day

The Food Standards Agency has issued new advice to pregnant women on daily caffeine consumption. Previously the advice was that 300mg a day (around 3 mugs of instant coffee or 4 mugs of tea) was a sensible limit. But in light of new research, they are now recommending that 200mg a day (around 2 mugs of instant coffee or 3 cups of tea), is a better limit. But the pregnant women who took part in the study were already having less than 200mg/day, so for many pregnant women this change in advice will not affect them.

This is because too much caffeine might result in a baby having a lower birth weight than it should, which can increase the risk of some health conditions in later life. There is also some evidence which suggests that high levels of caffeine can result in miscarriage. Caffeine occurs naturally in a range of foods, such as coffee, tea and chocolate, and it's also added to some soft drinks and 'energy' drinks.

Remember that caffeine is also found in certain cold and flu remedies, so always check with your GP or another health professional before taking any of these.

Junk food in pregnancy best avoided! 1st July 2008

Eating Junk Food during pregnancy may have a long term impact on your child's health suggests a study published in the Journal of Physiology.

The effects of a regular poor diet of junk food of pregnant and breastfeeding mums could lead to their children being prone to obesity, diabetes and heart disease. Dr Stephanie Bayol and Professor Neil Stickland from the Royal Veterinary College, London compared the offspring of rats fed a diet of processed junk food such as doughnuts, muffins, biscuits, crisps and sweets during pregnancy and lactation, and compared their offspring with those fed a healthy diet of regular feed.

The offspring of the mothers fed junk food diets had raised levels of cholesterol as well as higher levels of triglycerides, a type of fat found in the bloodstream. Both are known to increase the risk of developing heart disease.

Similarly, the offspring had higher levels of glucose and insulin, both of which increase the likelihood of developing type 2 diabetes. Dr. Bayol and her team say that the results are likely to apply to human beings.

It seems that a mother's diet whilst pregnant and breastfeeding is very important for the long term health of her child," says Dr Bayol. "We always say 'you are what you eat'. In fact, it may also be true that 'you are what your mother ate.'

“This does not mean that obesity and poor health is inevitable and it is important that we take care of ourselves and live a healthy lifestyle. But it does mean that mothers must eat responsibly whilst pregnant.”

Can I drink alcohol if I am pregnant? 26th March 2008

Guidance issued by the National Institute for Health and Clinical Excellence (NICE) in March 2008 includes recommendations for doctors and midwives on the advice they should give to pregnant women about drinking alcohol.

These recommendations are consistent with the advice issued in 2007 by the UK Chief Medical Officers. The recommendations are that:

pregnant women and women planning to become pregnant should be advised to avoid drinking alcohol in the first 3 months of pregnancy, because there may be an increased risk of miscarriage women should be advised that if they choose to drink alcohol while they are pregnant they should drink no more than 1-2 UK units once or twice a week.

There is uncertainty about how much alcohol is safe to drink in pregnancy, but at this low level there is no evidence of any harm to their unborn baby women should be advised not get to drunk or binge drink (drinking more than 7.5 UK units of alcohol on a single occasion) while they are pregnant because this can harm their unborn baby.

These recommendations confirm the Royal College of Obstetricians and Gynaecologists' (RCOG) view that the safest option for pregnant women is to abstain from consuming alcohol while pregnant. View the full RCOG response to this new guidance.

Here is a quick guide to UK units of alcohol:

1 unit alcohol = 10g alcohol

1 unit alcohol = 1 pub measure of spirits

1 unit alcohol = ½ pint ordinary strength beer/lager

1 unit alcohol = 1 glass of red or white wine

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