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Pregnancy and peanut butter: another example of information overload

Posted by Dr. Claire McCarthy  January 2, 2014 08:53 AM

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Thumbnail image for plum island 2005 084-2.jpgI am so glad that my first pregnancy was 23 years ago instead of now. I would go absolutely nuts now.
 
Speaking of nuts, the latest in the list of actually-never-mind bits of medical information is a study recently published in the Journal of the American Medical Association saying that it's totally fine for pregnant women to eat peanuts and tree nuts (assuming they aren't allergic to them). According to the study, it doesn't make it more likely that their babies will have a peanut allergy, which had been discussed as a possible explanation for why we are seeing so many children with peanut allergies. It turns out that eating peanuts and tree nuts during pregnancy may actually protect against allergy!

So, as so often happens, the medical advice changes. It is, I think, part of an information overload problem. 

Medicine is changing all the time; we learn new things every day. And each new discovery spawns more discoveries; there are times when I feel that what we know, and what we are learning, is literally exploding. I do a lot of reading to keep up, but I could read all day every day and not know everything. Medicine feels different than it did 23 years ago when I was pregnant with Michaela.

At the same time, we are in an age where access to information is exploding too. News travels nearly instantaneously. When I was pregnant with Michaela in 1990, the JAMA study would have been reported in the papers, where I might or might not have read about it. My obstetrician might or might not have heard about it quickly, depending on how much time he had to read journals. Information, especially medical information, moved more slowly and was less widely accessible. 

There were downsides to this, obviously. Getting good health information out to those who need it quickly can make all the difference, and well-informed patients can better advocate for themselves (and often get better care when they do). But there were upsides, too. Information had a time to sit, get put in context, get tried out, be interpreted and better understood. Sometimes, in the process, we realized that it didn't make sense. Doctors had a chance to explain things. We don't necessarily get that anymore.

So often these days, parents ask me questions that puzzle me. They puzzle me because I haven't heard anything about it (I am not the only doctor who has had to Google something because a patient heard about it before I did)--or because it would never have occurred to me to ask the question, let alone worry about it. But the way information get spun these days, it's hard not to worry--and react.

See, that's the thing: without medical training (actually, without specific medical training--even parents who are medically trained come to me with puzzling questions outside of their area of specialty) it's really hard to interpret information--and know if it has anything at all to do with you. And when information has to fit into the paragraph next to the picture on the website and be condensible into a 140 character Tweet, well, there's lots that gets left out.

Like nuance. Like the fact that so little in medicine is completely certain, that there is so much more gray than black or white.  Like the fact that risks are relative. Eating Brie cheese during pregnancy doesn't mean that you will get Listeria (the risk of contamination is 0.7%, or 7 per 1000 servings)--which is good, since I was blissfully unaware that I wasn't supposed to eat soft cheese during pregnancy and ate it nearly daily. We need to be aware of risks, but we need to keep perspective, too--after all, crossing the street or driving a car and other ordinary acts of daily life can get risky too. Sometimes the big picture is the most important one. 

And ultimately, each person and each situation is different.

I don't want to turn back the clock 23 years. I think that overall, things are better now. But we do need to be careful about anything we read or hear; it's important to take a deep breath and ask questions. And--this is really important--we need to talk to our doctors, and others with training and experience, as we sort through all that we hear and read. We need to understand that some significant percentage of the information we get will be reinterpreted or disproven in the future--and so be more thoughtful, less reactive.

We can never know everything, and there are never guarantees. Getting more information, and getting it more quickly, will never change that.



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This blog is not written or edited by Boston.com or the Boston Globe.
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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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