Q:

5/28/2014
A nursing mother has concerns regarding skin end point titration intradermal testing. She was concerned that following the test she may pass the antigens to the nursing baby through her breast milk potentially causing an anaphylactic reaction in the child. I could not specifically find any contraindications regarding nursing and SET. I would appreciate any further assistance regarding this matter.

A:

Thank you for your inquiry.

I am assuming that your skin tests are being performed to aeroallergens. In this case, I would consider allergy skin tests safe to administer during breast-feeding. Although there are no studies in this regard, perhaps the best way to answer your question is to cite a quote from the most recent guidelines (Parameters) on Allergen Immunotherapy, which discusses the administration of allergy injections during breast-feeding. As you know, injections contain the same allergens, but in larger doses than would be administered in skin testing. The above noted quote is copied for you below:

"There is no evidence of an increased risk of prescribing or continuing allergen immunotherapy for a mother while breastfeeding and no risk for the breast-fed child. SOURCE: Cox L, et al: Allergen immunotherapy: A practice parameter third update, Journal of Allergy and Clinical Immunology Vol. 127, Issue 1, Supplement, Pages S1-S55, 2011."

In addition, there is a website here with an opinion from a pediatric neonatologist about this subject that might be helpful to your patient, which also states the opinion that injections of allergen during breast-feeding are safe.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology