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A Parent’s Guide to Peanut Allergy

Learn what peanut allergy is, peanut allergy symptoms and trends, and how to manage and prevent peanut allergies. 

Peanut, along with milk and eggs, belongs to the top three allergens affecting children. It is more likely to be lifelong, with only 20% outgrowing a peanut allergy. Peanut is also more often linked to a severe and life-threatening allergic reaction or anaphylaxis, compared to other allergens. 

What is a Peanut Allergy?

If your child has a peanut allergy, their immune system sees peanuts as a harmful substance and releases antibodies to attack them. Peanuts are often confused with tree nuts, but the two are different. 

Peanuts are legumes that grow underground. They belong to the same family as soybeans and lentils. Tree nuts like hazelnuts, macadamia nuts, pecans, and cashews grow on trees. However, it may be observed that children who are allergic to peanuts are also allergic to tree nuts because they have proteins that are structurally similar.

Symptoms of Peanut Allergy

When someone suffering from a peanut allergy ingests peanuts or food with peanut in the ingredients, it may trigger an allergic reaction ranging from mild to severe.

Here are the symptoms of peanut allergy:

Skin: swelling, rash, hives, eczema

Eyes: itching, tearing, swelling and redness around the eyes

Respiratory: sneezing, runny nose, nasal congestion, coughing, chest tightness, difficulty breathing, wheezing

Mouth: swelling of the lips, tongue, palate or itching in the mouth

Gastrointestinal: nausea, gassiness, stomach pain or diarrhea

Cardiovascular: fast heartbeat, low blood pressure, dizziness, fainting 

Emergency care is needed when the allergic reaction affects more than one organ and if life-threatening symptoms are observed.  Sudden and severe symptoms, swelling of the face, tongue or throat, wheezing and breathing difficulty may signal an anaphylactic reaction. Allergic reactions may also recur hours after the first symptoms appeared. 

How is Peanut Allergy Diagnosed?

If your child experiences any of the symptoms mentioned above within seconds or minutes of ingesting peanuts, they may be allergic to peanuts. An allergist will be able to confirm and make a diagnosis through one or a combination of these tests: skin test, blood test, and oral food challenge.

With the skin test, the diluted allergen will be applied to the top layer of the skin. Sensitivity is detected when a red, itchy bump appears after coming into contact with a suspected allergen. Blood tests may be done if skin tests are challenging to administer. Blood tests look for and measure IgE antibodies in the blood. Both tests alone cannot be used to give a definitive diagnosis because it may still produce inaccurate results.

Elimination diet tests detect allergies through removing or isolating suspected allergenic food. Allergists may also conduct oral food challenge in a controlled medical facility. The allergenic food will be introduced in small doses and the allergist will look for symptoms of an allergic reaction. 

Peanut Allergy Trends

Peanut allergy affects up to 2% of children. This type of allergy is also more likely to be lifelong, with only 20% outgrowing it. A family history of food allergy and having eczema are risk factors for developing a peanut allergy. However, it has been found that over 50% of children with food allergies have no family history. Delaying food allergen introduction and vitamin D deficiency are also risk factors.

In recent years, the prevalence of peanut allergy in children has more than tripled in the US. Furthermore, food allergies may affect up to 6% of children and a survey suggests that peanut is the second most common cause of allergic reactions in schools. 

The Impact of Peanut Allergy

Peanut allergy may be frustrating for both the parent and the child. In social settings, it can feel isolating for the child. Eating out can be difficult as many foods may have peanut as an ingredient. It can be daunting for the parent to monitor what the child eats all the time. As many as 1 in 3 children with food allergies has also experienced bullying at least once.

While schools are starting to adopt peanut-free policies, it is recommended for parents and schools to improve awareness of food allergies and to educate themselves on managing all types of food allergies.

Management and Treatment

There is no known cure for peanut allergy, or for any other food allergy. Allergies are managed through avoidance, learning to recognize symptoms, and treating them promptly. This entails learning to recognize hidden peanut ingredients in food labels. Food Allergy Research & Education has a list of ingredients that may contain peanuts:

  •     Arachis oil (another name for peanut oil)
  •     Artificial nuts
  •     Beer nuts
  •     Cold-pressed, expelled or extruded peanut oil
  •     Goobers
  •     Ground nuts
  •     Lupin (or lupine)
  •     Mandelonas (peanuts soaked in almond flavoring)
  •     Mixed nuts
  •     Monkey nuts
  •     Nut meat
  •     Nut pieces
  •     Peanut butter
  •     Peanut flour
  •     Peanut protein hydrolysate

Other foods that may have peanuts are candies, chocolates, egg rolls, ice cream, nougat, pancakes, specialty pizzas, sauces, baked goods and pastries, nut butters, and vegetarian food products. Asian, African, and Mexican dishes are also known to use peanut as an ingredient.

Immunotherapy or food desensitization has been explored as a treatment option but is still undergoing studies. It is not yet known whether it really works.

Mild allergic reactions are treated with antihistamines or steroids prescribed by your healthcare provider or allergist. Severe allergic reactions or anaphylaxis are treated with a shot or two of epinephrine. In the case of anaphylaxis, your child needs to be taken to the emergency room for observation. This is because a second phase of allergic reaction might occur.

How to Prevent Peanut Allergy

Recent studies suggest that introducing infants to common allergenic foods like peanuts as early as 4 months of age can help reduce the risk of developing allergies by up to 80%. This practice should be sustained for at least several months to increase the chances of success. 

Allergenic foods should be introduced starting with small doses when your baby is healthy. An adult should be able to watch closely for any sign of reaction within two hours of consumption. It is also recommended to wait for 3 to 5 days before introducing a new potential allergen to make it easy to identify if the child has a reaction.





All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.

These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.  If your infant has severe eczema, check with your infant’s healthcare provider before feeding foods containing ground peanuts.


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