Peanuts—which are actually not nuts at all, but legumes, like lentils and peas—are the most common cause of severe food allergies in children. And the distinction is important: tree nuts, such as almonds, cashews and pecans can cause their own allergic reactions, but these nut allergies are typically less severe. An allergic reaction to peanuts, however, can lead to severe anaphylaxis (swelling), uncontrolled vomitting, cardiac arrest and even death. And it doesn’t take much, especially in young children: even trace amounts of peanut can lead to severe reactions in some cases. As a parent, this can be very scary. Fortunately, there are steps you can take with your family doctor to ensure that your child is properly diagnosed, treated and prepared in case of emergency.
The incidence of peanut allergy is on the rise, particularly among young children, so it’s a good idea to take your child to the doctor if you notice any strange reactions to food. Even mild symptoms, such as itchiness or rash, can worsen over the years, sometimes developing into full-blown anaphalyxis. When you see your family doctor for diagnosis, she will likely recommend one of the following:
- Blood test. This is a measure of allergen-specific antibodies, known as Immunoglobulin E (IgE), in the bloodstream.
- Skin Test. The skin is exposed to peanuts (usually an extract), followed by a needle prick. The doctor will then check for bumps and rashes.
- Elimination diet. Also known as an “oral challenge,” this test involves an elimination of peanuts for at least two weeks, followed by a steady increase in peanut exposure over time. If your child has experienced severe reactions in the past, this test is not recommended; the risk may be too high.
Once a peanut allergy has been identified, your child’s best bet is simply to avoid peanuts altogether. Provide examples of food items that contain peanuts, and teach them not to accept any food before asking. It’s also a good idea to inform teachers, coaches and friends about the allergy. Peanuts are common ingredients in baked goods, candies, energy bars, cereals and granolas, so diet management is very important. Otherwise, be ready with treatment options in case of a reaction.
If an allergic reaction does occur, epinephrine is the primary treatment for anaphylaxis. Be prepared by always carrying an autoinjector, such as an EpiPen or Twinject, and learn how to use the device just in case. The syringe should contain a complete dose, which can be injected with a needle in the upper thigh.
In case of severe reactions, such as abdominal pain and heavy asthma, it’s best to take your child to the ER or Urgent Care as well. Unfortunately, there are no approved therapies on the market to prevent or mitigate peanut allergy as such, but there have been recent advances that do show some promise. As a rule, strict avoidance is the best option to prevent allergic episodes; and, as always, hope for the best and prepare for the worst!