Being peanut aware: Living with a peanut allergy
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, macadamias, pistachios, pecans, and cashews.
The Allergic Reaction
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 into the body. One of these is histamine. The release of histamine can affect a person's respiratory system, gastrointestinal tract, skin, and cardiovascular system, causing allergy symptoms like wheezing, stomachache, vomiting, itchy hives, and swelling.
Reactions to foods, like peanuts and tree nuts, can vary. 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 less than a day and affect any of these four body systems:
- Skin: Skin reactions are the most common type of food allergy reactions. They can take the form of itchy, red, bumpy rashes (hives), eczema, or redness and swelling around the mouth or face.
- Gastrointestinal system: Symptoms can take the form of belly cramps, nausea, vomiting, or diarrhea.
- Respiratory system: Symptoms can range from a runny or stuffy nose, itchy, watery eyes, and sneezing to the triggering of asthma with coughing and wheezing.
- Cardiovascular system: A person may feel lightheaded or faint and lose consciousness.
In really bad cases, an allergy can cause anaphylaxis, a sudden, potentially life-threatening reaction that, besides the symptoms mentioned above, can make airways swell and blood pressure drop. As a result, a person may have trouble breathing and could lose consciousness
Peanut reactions can be very severe, even if someone isn't exposed to much peanut protein. Experts think this might be because the immune system recognizes peanut proteins more easily than other food proteins.
Although a small amount of peanut protein can set off a severe reaction, it is rare to have an allergic reaction just from breathing in small particles of nuts or peanuts. 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 the few 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. Although some people outgrow certain food allergies over time (like milk, egg, soy, and wheat allergies), peanut and tree nut allergies are lifelong in most people.
Living With Peanut or Tree Nut Allergy
If allergy 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 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:
- "may contain nuts"
- "produced on shared equipment with nuts or peanuts"
- "produced in a facility that also processes nuts"
- If you have nuts in your home, watch for cross-contamination that can happen with utensils and cookware. For example, make sure the knife you use to make peanut butter sandwiches is not used in preparing food for a child with a nut allergy, and that nut breads are not toasted in the same toaster as other breads.
- Don't serve cooked foods you didn't make yourself, or anything with an unknown list of ingredients.
- Tell everyone who handles the food your child eats, from waiters and waitresses to the cafeteria staff at school, about the allergy.
- Consider making your child's school lunches, as well as snacks and treats to take to parties, play dates, sleepovers, school functions, and other outings.
- Talk to the daycare supervisor or school principal before your child attends. Work together to create a food allergy emergency action plan.
- Keep epinephrine accessible at all times - not in the glove compartment of your car, but with you, because seconds count during an anaphylaxis episode.