Peanut allergy is common in children and appears to be increasing in frequency.  It often starts in early childhood and although a few children outgrow it, for most peanut allergy is life-long.  Also, even when the child appears to have outgrown the allergy, it can recur. 

Peanut allergy occurs when the body’s immune system mistakenly perceives peanut proteins as something harmful and develops allergic antibodies to these proteins. When the next exposure occurs, certain chemicals are released into the bloodstream producing the signs and symptoms of an allergic response.  This response can range from mild (hives, itching, stomach cramps) to life-threatening (shock, throat swelling, constricting of the airways).  A mild first reaction, however, does not guarantee that a more severe or life-threatening reaction won’t occur.

Symptoms of an allergic reaction:

• Hives, redness or swelling
• Itching or tingling in or around the mouth and throat
• Diarrhea, stomach cramps, nausea or vomiting
• Chest tightness
• Shortness of breath or wheezing
• Runny or stuffy nose
• Anaphylaxis

Anaphylaxis is a severe, life-threatening response to any substance that causes an allergic reaction; examples include exposure to peanuts, tree nuts, bee/wasp stings, seafood, etc.  Anaphylaxis can occur within seconds or minutes of exposure to the offending allergen and always requires treatment with epinephrine (EpiPen, Twinjet) plus a trip to the emergency room for observation and possible additional treatment.

Symptoms of anaphylaxis:

• Constriction of airways, including swollen throat and difficulty breathing
• Shock with a severe drop in blood pressure
• Rapid pulse
• Dizziness, lightheadedness or loss of consciousness

 People can be exposed to peanuts in several ways..

• Direct contact – eating peanuts or peanut-containing foods. Occasionally, exposure can occur from skin contact
• Cross-contamination – the unintended introduction of peanuts during processing or handling of a food. This can happen as simply as making a peanut butter and jelly sandwich using the same knife for both food items.  The jelly is then contaminated with peanuts making it unsafe to for the allergic person to eat.          
• Inhalation – inhaling dust or aerosols containing peanuts – peanut flour or peanut oil cooking spray.

 There are certain risk factors that make a person more susceptible to having an allergic reaction to peanuts.  These include having family members with allergies, especially to foods, and a previous allergic reaction to peanuts. 

 Treatment for peanut allergy:

1. Avoid peanuts and peanut products – read product labels carefully
2. EpiPen/Twinjet and emergency room visit for anaphylaxis
3. Antihistamines (Benadryl) for mild symptoms (itching or hives).  Antihistamines will not relieve anaphylaxis

 Common foods in which peanuts, peanut oils or trace amounts of peanuts may be present:

• Peanuts, ground nuts
• Peanut butter
• Baked goods – pastry, biscuits, cookies, crackers, health breads
• Asian foods – Thai, Chinese and Indonesian
• Vegetarian foods
• Cold pressed peanut oil (arachis oil)
• Muesli, granola and other cereals
• Ice creams and frozen desserts
• Mixed nuts, marzipan
• Soups
• Natural flavoring
• Egg rolls
• Health foods – nutrition and energy bars and other sweets
• Sauces

 What to do if your child has a peanut allergy:

1. Notify the people who regularly interact with the child – teachers, coaches, parents of the child’s friends, scout leaders, etc.
2. Always keep an epinephrine auto-injector (EpiPen, Twinjet) available for use in an emergency
3. Teach adults who spend time with the child the signs and symptoms of an allergic reaction
4. Have the child wear a medical alert bracelet or necklace
5. Write an action plan describing how to care for the child when he/she has an allergic reaction.
6. Discourage the child from sharing foods.