Peanut Allergy
Peanut allergy is a condition that causes the body's germ-fighting immune system to react to peanuts. It's one of the most common causes of a life-threatening allergic reaction to food. This life-threatening reaction is known as anaphylaxis. Peanut allergy has been increasing in children. Even if you or your child has shown only a mild reaction to peanuts, it's important to talk to a healthcare professional. There is still a risk of a more serious future reaction.
Peanut allergy occurs when the immune system flags peanut proteins as harmful. When exposed to peanuts, the immune system releases symptom-causing chemicals into the bloodstream. These chemicals cause an allergic reaction.
Direct and cross-contact with peanuts could cause a reaction:
Direct contact. The most common cause of peanut allergy is eating peanuts or foods that contain peanuts.
Cross-contact. This happens when peanuts get into a product by mistake. It often happens when food is exposed to peanuts during processing or handling.
Inhalation. Breathing in dust or aerosols containing peanuts, such as peanut flour, may cause an allergic reaction.
It isn't clear why some people develop allergies while others don't. However, people with certain risk factors have a greater chance of developing peanut allergy.
Peanut allergy risk factors include:
Age. Food allergies are most common in children, especially toddlers and infants. As a person grows, the digestive system matures. Then the body is less likely to react to food that triggers allergies.
Past allergy to peanuts. Some children with peanut allergy outgrow it, though it can recur. So be cautious even if you seem to have outgrown peanut allergy.
Other allergies. If you're already allergic to one food, you have a higher risk of being allergic to another. Also, having another type of allergy, such as hay fever, raises your risk of having a food allergy.
Family members with allergies. Your risk of peanut allergy is higher if other allergies are common in your family, especially other food allergies.
Atopic dermatitis. Some people with the skin condition atopic dermatitis, also called eczema, have a food allergy as well.
An allergic response to peanuts usually occurs within minutes after exposure. Peanut allergy signs and symptoms can include:
Skin reactions, such as hives, redness or swelling.
Itching or tingling in or around the mouth and throat.
Digestive problems, such as diarrhea, stomach cramps, nausea or vomiting.
Tightening of the throat.
Shortness of breath or wheezing.
Runny nose.
Peanut allergy is the most common cause of anaphylaxis due to food. This medical emergency requires treatment with an adrenaline/epinephrine autoinjector (EpiPen, Auvi-Q, others) and a trip to the emergency room.
Anaphylaxis signs and symptoms can include:
Constriction of airways.
Swelling of the lips, tongue and throat that makes it hard to breathe.
A severe drop in blood pressure, also known as shock.
Rapid pulse.
Dizziness, lightheadedness or loss of consciousness.
When to see a doctor:
Talk to your care team if you have had any signs or symptoms of peanut allergy. Seek emergency treatment if you have a severe reaction to peanuts.
Call, or have someone else call EMS/your local emergency number if you have any signs or symptoms of anaphylaxis such as:
Severe dizziness.
Severe trouble breathing.
Loss of consciousness.
The standard approach to care for peanut allergy is to avoid foods that contain peanuts. Yet researchers continue to study different therapies that will lessen the chance of severe reactions, including anaphylaxis. The only way to prevent a reaction is to avoid peanuts and peanut products altogether. However, peanuts are common. Even when you try your best, you're likely to come into contact with peanuts at some point.
For a severe allergic reaction, you may need an emergency injection of adrenaline/epinephrine and a visit to the emergency room. Many people with allergies carry an adrenaline/epinephrine autoinjector. This device is a syringe and hidden needle that injects a single dose of medicine when pressed against your thigh.
Know how to use your autoinjector
If your doctor has prescribed an autoinjector:
Carry it with you at all times. It may be a good idea to keep an extra autoinjector in your car and in your desk at work.
Always replace it before its expiration date. Out-of-date epinephrine may not work properly.
Ask your doctor to prescribe a backup autoinjector. If you misplace one, you'll have a spare.
Know how to operate it. Ask your healthcare team to show you. Also, make sure the people closest to you know how to use it. If someone with you can give you a shot, that person could save your life.
Know when to use it. Talk to a healthcare professional about how to know when you need a shot. If you're not sure, it's usually better to go ahead and use the emergency adrenaline/epinephrine.
One of the keys to preventing an allergic reaction is knowing how to avoid the food that causes your symptoms. Follow these steps:
Never assume that a food doesn't contain peanuts. Peanuts may be in foods that surprise you. Always read labels on processed foods to make sure they don't contain peanuts or peanut products. Processed foods are required to clearly state if foods contain any peanuts. Also, labels must state if foods were produced in factories that process peanuts.
Even if you think that you know what's in a food, check the label. Ingredients may change.
Don't ignore a label that says a food was produced in a factory that processes peanuts. Most people with a peanut allergy need to avoid all products that could contain peanuts, even trace amounts.
When in doubt, say "no thanks." At restaurants and social gatherings, there's always a risk of eating peanuts by accident. Many people don't understand how serious an allergic food reaction is. They may not know that a tiny amount of a food can cause a severe reaction. If you are at all worried that a food may contain something you're allergic to, don't try it.
Be prepared for a reaction. Talk with your doctor about carrying emergency medicines in case of a severe reaction.
Avoiding foods that contain peanuts. Peanuts are common. Avoiding foods that contain them can be hard. The following foods often contain peanuts:
Ground or mixed nuts.
Baked goods, such as cookies and pastries.
Ice cream and frozen desserts.
Energy bars.
Cereals and granola.
Grain breads.
Marzipan, a candy made of nuts, egg whites and sugar.
Some foods that may contain peanuts or peanut proteins are less obvious. They might have been made with peanuts or come in contact with them during processing. Some examples include:
Nougat.
Salad dressings.
Chocolate candies, nut butters such as almond butter and sunflower seeds.
Global foods including African, Chinese, Indonesian, Mexican, Thai and Vietnamese dishes.
Foods sold in bakeries and ice cream shops.
Arachis oil, another name for peanut oil.
Pet food.
If your child has peanut allergy, take these steps to help keep your child safe:
Involve caregivers. Ask relatives, babysitters, teachers and other caregivers to help. Teach the adults who spend time with your child how to recognize signs and symptoms of an allergic reaction to peanuts. Emphasize that an allergic reaction can be life-threatening and requires immediate action.
Also, make sure that your child knows to ask for help right away in case of an allergic reaction.
Use a written plan. Write down the steps to take in case of an allergic reaction. Include the order and doses of all medicines to be given. List contact information for family members and healthcare providers. Give a copy of the plan to family members, teachers and others who care for your child.
Discourage your child from sharing foods. It's common for kids to share snacks and treats. However, while playing, your child may forget about food allergies or sensitivities. If your child is allergic to peanuts, encourage your child not to eat food from others.
Make sure your child's epinephrine autoinjector is always available. An injection of epinephrine needs to be given right away to reduce the chance of anaphylaxis. Make sure caregivers and family members know about your child's emergency medicine. They should know where the autoinjector is located, when it may be needed and how to use it.
Make sure your child's school has a food allergy management plan. Guidelines are available to create policies and procedures. Staff should have access to an epinephrine injector and be trained how to use it.
Have your child wear a medical alert bracelet or necklace. This will help your child get the right treatment if communication isn't possible during a severe reaction. The alert will include your child's name and the type of food allergy. Also, it may list brief emergency instructions.
