Peanut Allergies

For many people, peanuts are a familiar snack food enjoyed at baseball games or on airplanes. Yet for some, even inhalation of small amounts of peanut particles can cause a severe and potential deadly allergic reaction. In recent years, peanut allergies have become a hot topic in childcare facilities and schools; children are a large segment of the three million people who suffer from peanut and tree nut allergies.

Carolyn Lattin's preschooler has a peanut allergy, and Carolyn has become the well-informed voice of her daughter's needs. It started for their family when Carolyn's infant daughter had several eczema-type rashes. Carolyn didn't think much about it at the time, and it wasn't until her daughter first had peanut butter at 12 months of age that the pieces fell together. Upon tasting the peanut butter her daughter vomited, turned red, and started to swell. A trip to the emergency room plus a dose of Benadryl® and the previous rashes all added up to a food allergy. A series of skin and blood tests confirmed the young girl's allergies included peanuts, tree nuts, sesame, chickpea, and pinto beans.

Peanuts are one of the most commonly restricted foods in children and adults due to allergic reactions, according to the American Academy of Allergy, Asthma, and Immunology (AAAAI). Although there does not appear to be a strong genetic link, children with allergic parents are more likely to have an allergic reaction as well. The Allergy Report, from AAAAI, gives the following list of foods that cause 90 percent of the allergic reactions to food (note that peanuts are actually considered a legume and are separate from tree nuts):

In Children:

1. Milk
2. Eggs
3. Peanuts
4. Wheat
5. Soy
6. Tree nuts

In Adults:

1. Peanuts
2. Tree nuts
3. Fish
4. Shellfish

According to Traci Tavares, communications director for the Food Allergy and Anaphylaxis Network, allergies are often caused by foods familiar to the diet. She notes, as an example, that in Asian countries, rice allergies are much more prevalent than in the United States.

Current research is strongly encouraging breastmilk only for the first four to six months of life. Earlier introduction of nonmilk foods has been correlated to increased incidence of infection and allergy. This early food introduction is possibly more problematic in children with a strong family history of allergies. And in these cases it is further recommended that the mother refrain from eating potentially allergenic foods that may pass through the breastmilk, often starting with the elimination of peanuts and tree nuts (almonds, walnuts, etc.)

In another study, babies born by Cesarean birth may be more likely to develop a food allergy due to lack of exposure to the bacteria in the birth canal. This delay in the colonization of bacteria in the baby's intestine is thought to increase allergies. In one study in Sweden that incuded 2800 children there was a 7 fold increase in the number of food allergies with C-section births.

Diagnosing a Peanut Allergy

The diagnosing of a food allergy should be done by an allergist using blood or skin tests. An allergist can determine if a set of symptoms is related to an allergic reaction to food or a more simple food intolerance. A food intolerance is an adverse reaction to a particular food that does not involve the immune system, whereas a food allergy occurs when the immune system mistakenly reacts to a harmless food as if it were dangerous. After physical contact with the food, either touching or swallowing, the immune system attempts to protect the body by creating antibodies. The next time the food is touched or eaten these antibody chemicals are released, creating numerous symptoms that can affect the respiratory system (lungs), the gastrointestinal tract (digestion), cardiovascular system (heart), and skin (rash). Symptoms can range from a tingling in the mouth, rash or hives, swelling of the tongue or throat, abdominal cramps, wheezing, breathing difficulties, vomiting, diarrhea, loss of consciousness, or anaphylaxis which can lead to death.

According to Dr. James Wille, board certified in both pediatric and adult allergy and asthma, the reaction time for symptoms to occur after exposure to peanuts, or any allergen, is often within minutes. The longer the reaction time is delayed, the less severe the problem, he stated. He also noted that, although possible, it is rare to be sensitive to airborne peanut fumes.

Managing a Peanut Allergy

The best management of any food allergy is avoidance, according to the AAAAI. Eliminating the offensive item from the diet resolves the problem. Yet this is much easier said than done in many cases. Most of the top allergy foods are also very commonly used foods. Peanuts, peanut butter, and peanut oil are in many foods. Dr. Wille adds that allergies are responses to food proteins and not the fat part of a molecule, so technically oils should be safe, but they are often contaminated with small protein particles that don't get filtered out and must be avoided. He does say that ultra refined peanut oil could be safe, yet it is expensive and not widely available.

To avoid foods that cause reactions, label reading becomes a crucial parenting skill. "You need to be your or your child's own best advocate—if you don't know, don't eat it," advises Dr. Wille. Carolyn agrees. She often calls companies right from the grocery store aisle to understand manufacturing processes, since a product may carry no warning but will be made on a line that also makes products containing nuts. She says it is not particularly hard to shop for her family, and notes that they probably eat healthier because of her daughter's condition. She says commercially baked cookies, muffins, desserts, candy, and pre-made food in salad bars and deli cases are eliminated due to the potential contact with peanut butter or oils, so homemade is the safest route.