Moms who breastfeed babies with food allergies may be more anxious, depressed

Women who altered their diets to breastfeed children with food allergies had more psychosocial symptoms affecting bonding with their babies than breastfeeding mothers who did not need to alter their diets, according to a study.

Ozlem Yimaz, MD, associate professor of pediatrics at Koç University in Istanbul, and colleagues recruited 153 mother-infant dyads between January 2016 and August 2017, including 64 healthy controls and 89 with food allergies (FA), which included 75 infants with non-IgE-mediated FA (84.2%), 10 with IgE-mediated FA (11.2%), and four with IgE- and non-IgE-mediated FA (4.5%). Mean age of the mothers was 31.1 years ± 4.7 years and mean age of the infants was 6.3 months ± 3.6 months.

During routine outpatient clinic visits, participants completed standardized questionnaires about their sociodemographics and their allergic, psychiatric and physical disease histories. The researchers reported no difference in psychiatric history between the FA and control groups.

The mothers also reported on their dietary histories including foods they had eliminated from their diets and on their sources for dietary recommendations.

The elimination diets among the dyads with FA had a mean duration of 103 ± 81 days, and the diets were most commonly started upon doctor recommendation. Advice from the internet and written sources were the second and third most common reasons for food elimination.

The most common foods eliminated from these diets included eggs, milk, red meat and tree nuts, which also were their main sources of protein and calcium. Also, 41% of the mothers in the FA group eliminated more than 20 nutrients from their diets.

According to the results, published in Pediatric Allergy and Immunology, 69% of the mothers in the FA group said the foods they eliminated were very important to them and that avoiding many of these foods very seriously affected their lives. Plus, 77% of them said they lost weight.

Based on the Symptom Checklist 90 scale, the women in the FA group had higher scores in anxiety (P = .008), anger (P = .042), depression (P < .001), interpersonal sensitivity (P = .001), obsession (P = .008), somatization (P = .002) and general symptom index (P = .001) than mothers from the healthy control group.

Additionally, the FA group had higher scores in the Beck Depression Inventory (P .001), Beck Anxiety Inventory (P = .008) and Brockington Postpartum Bonding Questionnaire, including in attachment (P = .001), anger (P = .019) and total scores (P = .036).

Specifically, the mothers of infants with non-IgE-mediated cases of FA had higher scores in each of these parameters than mothers of infants with IgE-mediated FA.

The researchers concluded that food allergies among infants are negatively linked to psychosocial states among breastfeeding mothers. They also noted that an FA diagnosis, daily management of allergen avoidance, anxiety and fear of unpredictable allergic reactions all present a great psychological burden for these families.

In addition to the other symptoms studied, the researchers cited the mothers’ phobias, feelings of inadequacy and expectations of rejection and criticism, adding that these mothers may have become overprotective to cope with their babies’ FA symptoms.

“It is highly likely that breastfeeding mothers may feel guilty themselves due to food allergens passing via their breast milk,” the researchers wrote. “When the possibility of harming their infants come together with the great responsibility of feeding, mothers may experience stress and feel helpless. They may be afraid of harming their infants and begin extensive elimination diets with great desperation.”

The researchers suggested that mothers could be reassessed if these FA go into remission, which would help answer whether these psychosocial problems are pertinent to the mothers themselves or related to the burdensome aspects of FA.

Further, the researchers wrote that mothers who avoid major foods to take care of their infants with FA should get psychologic and social support.