First grade has been a difficult parenting year for Anne. Her 6-year-old son, Justin, began eating lunch in the cafeteria with hundreds of other students armed with their peanut butter sandwiches, peanut butter crackers, and all those hidden peanuts in their processed foods.
For Justin, who has an extremely severe allergy to peanuts, it means sitting at a peanut-free table. But Justin isn't alone: About 5% of school-aged kids have some kind of food allergy, putting them at risk of an allergic reaction at home or, even more dangerously, away from home.
Peanuts are among the most common allergy-causing foods, and they often find their way into things you wouldn't imagine. Take chili, for example: It may be thickened with ground peanuts.
Peanuts are actually not a true nut, but a legume (in the same family as peas and lentils). But the proteins in peanuts are similar in structure to those in tree nuts. For this reason, people who are allergic to peanuts also can be allergic to tree nuts, such as almonds, Brazil nuts, walnuts, hazelnuts, macadamia nuts, pistachios, pecans, and cashews.
An allergic reaction happens when someone's immune system mistakenly believes that something harmless, such as a tree nut or peanut, is actually harmful. The immune system responds by creating specific antibodies to proteins in that food. These antibodies — called immunoglobulin E (IgE) — are designed to fight off the "invading" proteins.
IgE antibodies trigger the release of certain chemicals in the body. One of these is histamine. The release of histamine can affect the respiratory system, gastrointestinal tract, skin, and cardiovascular system, causing allergy symptoms like wheezing, stomachache, vomiting, itchy hives, swelling, and a drop in blood pressure.
Reactions to foods, like peanuts and tree nuts, can be different. It all depends on the person — and sometimes the same person can react differently at different times. Some reactions can be very mild and involve only one system of the body, like hives on the skin. Other reactions can be more severe and involve more than one part of the body.
Most reactions last a few hours or less, and affect any of these four body systems:
In really bad cases, an allergy can cause anaphylaxis, a sudden, potentially life-threatening reaction. Besides the symptoms mentioned above, anaphylaxis can make airways swell and blood pressure drop. As a result, a person may have trouble breathing and could lose consciousness.
Even a small amount of peanut or tree nut protein can set off a severe reaction. But allergic reactions just from breathing in small particles of nuts or peanuts are rare because the food needs to be digested to cause a reaction. Most foods with peanuts in them don't allow enough of the protein to escape into the air to cause a reaction. And just the smell of foods containing peanuts won't produce a reaction because the scent does not contain the protein.
In very rare cases when people do react to airborne particles, it's usually in an enclosed area (like a restaurant) where lots of peanuts are being cracked from their shells. The person inhales and then swallows the protein, which can lead to a reaction when the protein gets digested. Although some people outgrow certain food allergies over time (like milk, egg, soy, and wheat allergies), peanut and tree nut allergies are lifelong in many people.
If allergy skin testing shows that your child has a peanut or tree nut allergy, a doctor will provide guidelines on what to do.
The best way to prevent a reaction is to avoid peanuts and tree nuts. Avoiding these nuts means more than just not eating them. It also means not eating any foods that might contain tree nuts or peanuts as ingredients.
The best way to be sure a food is nut-free is to read the label. Manufacturers of foods sold in the United States must state on their labels whether the foods contain peanuts or tree nuts. Check the ingredients list first.
After checking the ingredients list, look on the label for phrases like these:
People who are allergic to nuts also have to avoid foods with these statements on the label. Although these foods might not use nut ingredients, the warnings are there to let people know they might contain traces of nuts. That can happen through "cross-contamination," when nuts get into a food product because it is made or served in a place that uses nuts in other foods.
Some of the highest-risk foods for people with peanut or tree nut allergy include:
Always proceed with caution. Even if your child has eaten a food in the past, manufacturers sometimes change their processes — for example, switching suppliers to a company that uses shared equipment. And two foods that seem the same might have differences in their manufacturing.
To help reduce contact with nut allergens and the possibility of severe reactions in someone with a peanut or tree nut allergy:
With a little preparation and prevention, you can make sure that your child's allergy doesn't get in the way of a happy, healthy everyday life.
Reviewed by: Magee DeFelice, MD, and Alana Kekevian, DO
Date reviewed: October 2014
|American Academy of Allergy, Asthma, and Immunology The American Academy of Allergy, Asthma, and Immunology offers up-to-date information and a find-an-allergist search tool.|
|American College of Allergy, Asthma, and Immunology The ACAAI is an organization of allergists-immunologists and health professionals dedicated to quality patient care. Contact them at: American College of Allergy, Asthma, and Immunology|
85 W. Algonquin Road
Suite 550 Arlington Heights, IL 60005
|The Food Allergy and Anaphylaxis Network (FAAN) The FAAN mession is to raise public awareness, provide advocacy and education and to advance research on behavior for all of those affected by food allergies and anaphylaxis.|
|What Is Skin Testing for Allergies? A scratch or skin prick test is a common way doctors find out more about a person's allergies.|
|All About Allergies Up to 50 million Americans, including millions of kids, have an allergy. Find out how allergies are diagnosed and how to keep them under control.|
|Babysitting: Dealing With Allergic Reactions What should you do if a child you're babysitting has an allergic reaction? Our tip sheet can help you be prepared.|
|Food Allergies and Travel Taking precautions and carrying meds are just part of normal life for someone who has a food allergy. Here are some tips on how to make travel also feel perfectly routine.|
|My Friend Has a Food Allergy. How Can I Help? Although food allergies are more common than ever, people who have them may feel different or embarrassed. A good friend can really help.|
|Figuring Out Food Labels Find out how to make healthy food choices for your family by reading food labels.|
|Milk Allergy Milk allergy can cause serious reactions. Find out how to keep kids safe.|
|My Girlfriend Has a Peanut Allergy. Do We Have to Worry About Kissing? Find out what the experts have to say.|
|Food Allergies and Food Sensitivities Find more than 30 articles in English and Spanish about all aspects of food allergies in children.|
|Shellfish Allergy Shellfish allergy can cause serious reactions. Find out common symptoms of allergic reactions and how to respond.|
|Food Allergies Struggling with strawberries? Petrified of peanuts? Sorry you ate shellfish? Maybe you have a food allergy. Find out more in this article for kids.|
|Milk Allergy Milk is in all kinds of foods, even things like baked goods. So what should a person who's allergic to milk do?|
|Milk Allergy in Infants Almost all infants are fussy at times. But some are excessively fussy because they have an allergy to the protein in cow's milk, which is the basis for most commercial baby formulas.|
|Serious Allergic Reactions (Anaphylaxis) Kids with severe allergies can be at risk for a sudden, serious allergic reaction called anaphylaxis. The good news is it can be prevented and treated.|
|Going to School With Food Allergies With preparation and education, a child with a food allergy can stay safe at school.|
|Soy Allergy Soy is found in many foods and it's a common food allegy. Find out how to help kids with an allergy stay safe.|
|Serious Allergic Reactions (Anaphylaxis) A person with severe allergies can be at risk for a sudden, serious allergic reaction called anaphylaxis. This reaction can seem scary, but the good news is it can be treated.|
|5 Ways to Be Prepared for an Allergy Emergency Quick action is essential during a serious allergic reaction. It helps to remind yourself of action steps so they become second nature if there's an emergency. Here's what to do.|
|Food Allergies Food allergies can cause serious and even deadly reactions in kids, so it's important to know how to feed a child with food allergies and to prevent reactions.|
|What's the Difference Between a Food Allergy and a Food Intolerance? Food allergies and food intolerances, like lactose intolerance, are not the same. Find out more.|
|Wheat Allergy Wheat allergy can cause serious reactions. Find out how to help kids with an allergy stay safe.|
|Fish Allergy Fish allergy can cause a serious reaction. Find out how to keep kids safe.|
|Shellfish Allergy Shellfish allergies can be serious - and shellfish can appear in some surprising foods and products. Read about shellfish allergy and what to do when a reaction is severe.|
|Food Allergies Doctors are diagnosing more and more people with food allergies. Knowing what to expect and how to deal with food allergies can make a big difference in preventing serious illness.|
|If I Have a Nut Allergy, Can I Eat Coconut? Is coconut a nut? And if so, should you watch out if you're allergic to nuts? Find out more in this article for kids.|
|Hives (Urticaria) Has your child broken out in welts? It could be a case of the hives. Learn how to soothe itchy bumps and help your child feel better.|
|Allergy Testing Doctors use several different types of allergy tests, depending on what a person may be allergic to. Find out what to expect from allergy tests.|
|Egg Allergy Babies sometimes have an allergic reaction to eggs. If that happens, they can't eat eggs for a while. But the good news is that most kids outgrow this allergy by age 5.|
|Nut and Peanut Allergy A growing number of kids are allergic to nuts and peanuts. Find out more about this problem and how allergic kids can stay healthy.|
|Nut and Peanut Allergy Peanuts are one of the most common allergy-causing foods, and they often find their way into things you wouldn't imagine. Learn the facts on living with a nut or peanut allergy.|
|Egg Allergy Living with an egg allergy means you have to be aware of what you're eating and read food labels carefully. Here are some tips for teens who have an egg allergy.|
What to expect when coming to Akron Children's
For healthcare providers and nurses
Residency & Fellowships, Medical Students, Nursing and Allied Health
For prospective employees and career-seekers
Our online community that provides inspirational stories and helpful information.