Peanut butter and jelly sandwiches have long been a staple in a child’s diet, but for a growing segment of children, this typical lunch could cause a life-threatening reaction. Peanut allergy, estimated to affect approximately 400,000 school-aged children in the United States, is one of the food allergens most commonly associated with sudden and severe reactions such as anaphylaxis. In recent years, awareness about peanut allergy in children has risen, coinciding with the rise in the prevalence rate. One study concluded that the incidence of peanut allergy among children more than tripled from 1997 to 2008.
There are several misconceptions about peanut allergies. A peanut is a legume (belonging to the same family as soybeans, peas, and lentils), not a tree nut. And while it was previously believed that peanut allergy was lifelong, studies have shown that about 20 percent of individuals with peanut allergy eventually outgrow it.
Peanut allergy treatment
Individuals allergic to peanuts should be prescribed an epinephrine (adrenaline) auto-injector to carry with them at all times, because peanut allergy reactions are unpredictable and may vary in their severity.
Peanut allergy Foods to avoid
While peanuts may seem to be less difficult to avoid than allergens such as wheat, food-manufacturing practices at many facilities frequently use peanuts in some products and not others, creating a risk of cross-contact. Individuals with peanut allergy should avoid products that bear precautionary statements (i.e., “may contain”) for peanuts on the label.
Peanut-allergic individuals must also be vigilant in restaurants, where peanuts may appear as a “hidden” ingredient. For example, some chefs may use peanut butter in the preparation of sauces or marinades. People with peanut allergy should also be extra careful when dining at restaurants where peanuts are commonly used in the cuisine (e.g., Asian and Mexican), and at ice cream shops, where peanuts are a common topping and the possibility of cross-contact is high. Additionally, peanuts are commonly found in candies, cereals, and baked goods such as cookies, cakes, and pies, to name just a few.
When cooking from scratch, recipes can be easily modified to remove peanut ingredients, substituting toasted oats, raisins, or seeds if these ingredients are not restricted from the diet. Some families managing a peanut allergy have found success with soy nut or sunflower seed butter products as substitutes. Keep in mind, however, that these products may be manufactured in a facility that also processes peanuts—so check the label carefully and contact the manufacturer with any questions.
Frequently asked peanut allergy questions
Is inhaling peanut allergens risky?
An allergic reaction to peanut is triggered by contact with peanut protein. While there are case reports involving the onset of symptoms such as skin rashes or chest tightness from being in the presence of or smelling peanut butter, a blind, placebo-controlled trial of children exposed to open peanut butter documented no systemic reactions.
However, food particles containing proteins can become airborne. This might occur, for example, during grinding or pulverization of peanuts that disperses particles in the air. Inhaling peanut protein in this type of situation could cause an allergic reaction, but usually not anaphylaxis. Odors may cause conditioned physiologic responses such as a skin rash or change in blood pressure.
Can I have peanut oil if I have a peanut allergy?
Most individuals with an allergy to peanuts can safely eat peanut oil (not cold pressed, expelled, or extruded peanut oil). Ask an allergist whether or not you should avoid this ingredient.