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Peanut & Tree Nut Allergies


Having a child diagnosed with a peanut or tree nut allergy is understandably scary. Here we give you the necessary information to safely manage your child’s diet with the least amount of stress!

What are peanuts and tree nuts?

Tree nuts include walnuts, almonds, hazelnuts, cashews, pistachios, and Brazil nuts. Note that coconut is not a tree nut and is usually well-tolerated by people with tree nut allergy.

Peanuts are technically legumes and not nuts. Peanut and tree nut allergies are different. However, different nuts often come in contact with one another during food manufacturing.

Some allergists recommend that people with one specific nut allergy avoid all peanuts and tree nuts. Ask your allergist what they recommend for your child.

What is peanut or tree nut allergy?

An allergy to peanuts or tree nuts means that your child’s immune system over-reacts when your child eats anything containing a particular nut. Signs of this “over-reaction” (an allergic reaction) may be hives, swollen itchy spots on the skin, an itchy mouth or throat, or a runny/congested nose.

Some people with food allergies have an anaphylactic reaction. This means the allergic reaction becomes life-threatening and affects the ability to breathe.

Someone can have a mild reaction to peanuts one time and an anaphylactic reaction another time. Because of this, your doctor will likely recommend that you carry an epinephrine auto-injector with you at all times, in case your child has a severe reaction.

How does an allergic reaction happen?

In order for your child to have an allergic reaction, she must come in contact with either peanuts or tree nuts. Your child cannot have a reaction by breathing in the smell of peanuts or tree nuts.

But there have been cases where someone in an enclosed area where peanuts were being crushed inhaled some peanut particles and developed an allergic reaction. This is a very unusual situation though.

Your child could, however, react if she touched peanut butter and then touched her eyes, nose, or mouth. This is why a peanut allergy is hard for young children. They could easily touch a surface with leftover peanut butter residue (like another child’s hand or a picnic table), then put their hands in their mouths.

How can I prevent my child from having an allergic reaction?

Preventing a reaction means your child needs to avoid ALL foods containing whatever specific tree nut/peanut they are allergic to. Again, your allergist may recommend your child avoid all tree nuts and peanuts.

Food labels in the US are required by law to say if a food contains peanuts or tree nuts (since they are such popular allergens) in one of two ways:

  1. By listing the allergen in the ingredients, such as “Ingredients: Wheat, peanuts, salt.”

  2. By having an allergy statement at the end of the ingredient list, for example, “Contains almonds”.

Some labels will say “Made in a facility that processes peanuts and tree nuts.” This means the food manufacturer can’t guarantee that the food is nut-free. The product may have come in contact with nuts in the factory, even if nuts weren’t an intended ingredient. Your allergist will guide you on whether or not your child should avoid foods with this statement on the label.

General tips

  • Label reading: Food manufacturers can change ingredients at any time without informing consumers. Read food labels every time you shop.

  • School: Make sure your child knows not to share another child’s food.

  • Parties: Before your child attends a birthday party, let the host know about your child’s allergy. If they can’t guarantee the food and cake will be nut-free, bring your own. It’s very important to let your child participate in activities like birthday parties, even if she has to eat a different dessert.

  • Restaurants: Ask to speak with the chef before ordering. They will help you choose nut-free dishes.

  • Teenagers: It is possible for a teen with a peanut allergy to have a reaction from kissing someone who has recently eaten peanuts. If you have a child old enough to date, make sure they know this.

  • The world is not nut-free. There’s a chance your child is about to sit at a mall food court table where someone just ate peanut noodles. Carry wipes with you and wipe down the table and chair surfaces before your child sits down.

  • Make sure you, babysitters, and grandparents always carry an epinephrine auto-injector and know how to use it.

Tricky foods containing nuts

  • Asian cuisines (Thai, Chinese, etc.) often contain peanuts

  • Baked goods like brownies or banana bread may contain walnuts or other nuts

  • Mortadella (may contain pistachios)

  • Pesto (contains pine nuts, also known as pignolis)

  • Tree nut oils (e.g. walnut oil) can be found in flavored coffees and skin-care products like lotions

  • Nutella (contains hazelnuts)

  • Nut milks (almond milk, cashew milk, etc.)

  • Salad dressings or marinades

  • Ice cream parlors are risky for a child with a peanut allergy. Peanuts are commonly used as toppings and in some ice cream flavors.

If you want to know more about effective ways to manage your child’s food allergy, please contact us.

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