Peanut Allergy Pointers

Step 1: Avoidance

Avoidance of peanut allergens by reading food labels is the first step in management. Here are a few good tips to remember to avoid accidental exposure to peanuts:

• Avoid foods that contain ingredients such as beer nuts; cold pressed, expelled or extruded peanut oil; goobers; ground, mixed, monkey or artificial nuts; nut meat; nut pieces; peanut butter; or peanut flour
• Remember that certain ethnic foods such as Chinese, Indian, Thai and Vietnamese dishes, as well as many chocolate candies and baked goods are likely to include peanut as an ingredient
• Avoid foods that are made in facilities that process peanuts. For example, sunflower seeds are often produced on equipment shared with peanuts
• Many experts advise that tree nuts (almonds, pecans, etc.) should also be avoided due to risk of cross contamination
• Studies show that most peanut allergic individuals can safely eat peanut oil (other than cold pressed, expelled or extruded peanut oil)
• When eating out, always make a server aware that your child has a peanut allergy and ask about possible hidden ingredients or food contaminants. 

Step 2: Recognizing the signs

Allergic reactions to peanuts typically begin within minutes to a few hours after eating the offending food. The frequency and severity of symptoms vary widely from one child to another. Mildly allergic children may only experience and itchy nose and sneezing, while highly allergic children may experience severe and life-threatening reactions, such as asthma or swelling of the tongue, lips or throat.

Step 3: Managing a reaction

Children with a peanut allergy should have a clearly defined plan of action for handling emergency situations. Keep a list of symptoms and your child’s doctor's instructions for treatment posted in a prominent place in your kitchen, such as the refrigerator.

Oral antihistamines can be very effective in treating many of the early symptoms of a mild allergic reaction to food. Children with histories of severe reactions need to be instructed how and when to give themselves a shot of epinephrine in the event of a severe allergic reaction. Epinephrine can slow or reverse life-threatening reactions (anaphylaxis) before medical help can arrive. This medication is available in easy-to-use injectable devices and should be carried at all times by children with histories of severe allergic reactions. Bracelets or necklaces may be worn to quickly alert medical personnel or other caretakers to the food allergy.

Back to school

• Communicate with school staff Before the academic year begins, meet with your child’s teacher, principal, nurse and other staff to discuss allergy triggers and reactions. Prepare a food allergy action planto keep on file at the school (find a template at www.aaaai.org). Include a photo of the child with the form to simplify identification.
• Provide safe situations If necessary, work with school administrators to create allergy-free dining areas (such as a peanut-free table in the cafeteria). Send safe treats from home for classroom parties, fieldtrips and other special activities
• Explain the danger Have an age-appropriate conversation with your child about the risk of food allergies. Talk about safe and unsafe food and review the list . Remind your child not to share lunches or accept offers of food from classmates. Encourage your child to notify an adult immediately if he or she eats something that may cause a reaction or begins to experience symptoms.
• Keep medication available Work with school healthcare providers to keep physician-approved medications available. Mild reactions often require treatment with antihistamines. Children at risk of severe reactions should have injectable epinephrine within reach (older children can carry their medication with them; younger children should have it available in the classroom). Have your child’s physician provide written instructions for administering epinephrine and confirm that school staff members understand their responsibility to act quickly. Medications should also be brought to all off-campus school events.