The AAAAI strongly recommends reading the list of ingredients on every package. Unlike other allergies, peanuts are listed clearly on labels as "peanuts" or "peanut oil," so they are easy to spot. Milk use can be more difficult to determine because it can also be listed as "lacto," "whey," or "casein."
Some companies are going a step further to print warning labels that a food's contents contain peanuts or may have come into contact with peanuts. Unfortunately, the warning labels do not yet provide uniform information. Ms.Tavares says the warning labels often mean different things—to one company it means that no peanuts were used on that production line (but may have been in the building), while to another company it means that the equipment has been sanitized after peanuts are used, and to yet another company it means peanuts are always on the premises. Efforts to standardize this information are underway.
When eating out, the advice from everyone remains much the same—if you don't know, don't eat it. Ask if peanuts or peanut oils are used in any of the cooking; if they have been, there is a chance that residue can remain on a pan or cooking surface. Some restaurants print a "peanuts used on the premises" warning.
Since so many people have serious nut allergies, peanuts and tree nuts have been eliminated from many sectors of society—including daycares, schools, and airline flights. Due to the unpredictable nature of children and their need to explore, often times young children come into contact with allergens by accidentally eating someone else's food or touching a spot where another child had left food residue. Because of this, Carolyn helped her daughter's preschool to become nut free. She found that, once informed of the severe nature of food allergies, parents and caretakers were very supportive of the school's nut-free designation.
What Can a Parent Do?
Since peanut protein can be excreted in breast milk, a mother should try to eliminate peanuts from her diet while nursing. Start by delaying the introduction of sensitive foods. Dr. Wille recommends waiting until a child is 12 to 15 months old before introducing peanut products – similar to the time milk is introduced. If a child is of parents with a history of allergies, it is best to further delay peanut products until the child is three years old, thus giving the gut more time to mature.
If a child is already allergic to peanuts, use the following steps to make this issue manageable:
- know that, unlike other allergies that are often outgrown by about the age of 10, peanut allergies are considered life-long conditions
- work with an allergist for condition management
- work with a dietitian on appropriate food choices
- use the websites of the Food Allergy and Anaphylaxis Network, www.faan.org, and Food Allergy Network, www.foodallergy.org as resources
- be an advocate for your child—educate people around your child about the condition and necessary food avoidances
- always have antihistamine and an EpiPen® available for any accidental intake.
Treatment for a peanut allergy reaction includes antihistamines, i.e. Benadryl®, for less severe problems to epinephrine (adrenaline) for severe reaction control. Prescription epinephrine should always be available, in the form of EpiPen® autoinjectors, for severe cases. Ms. Tavares states that an allergy medicine is progressing through the FDA channels and will hopefully be available in the years to come.