Peanut Allergy In Kids: A Full Guide To Symptoms, Treatment, And More

Peanut Allergies In Kids: A Comprehensive Guide To Symptoms, Testing, Treatment, And More

March 6, 2020 Updated September 30, 2020

peanut-allergy
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Peanut allergy — just the phrase sends cold shivers down the spine of parents and caretakers who have to help an allergic child navigate a world where peanuts, or traces of it, are everywhere.

By now we all know the dangers of rashes and anaphylactic shock related to the popular legume (that’s right, peanuts are a legume, like peas!), which is why giving our little ones their first tastes of peanuts can be so scary. And as more children are diagnosed with peanut or other common food allergies, the beloved peanut spread that was basically 90 percent of our diet as kids is now the bane of every preschool — and for good reason. Taking the allergy seriously — whether your child has it or not — is the only way to avoid a potentially deadly reaction.

The truth is that a peanut allergy can be scary and overwhelming to deal with, especially if it’s our kids who suffer from it. Luckily we have some helpful advice on how to navigate the terrifying and anxiety-inducing world of peanut allergies from Dr. Jennifer Collins, an allergist with eight years of experience and Dr. Tricia Lee, a pediatric allergist at Hudson Tribeca.

They help break down the dangers, clear up some common misconceptions, and offer some helpful guidance on discussing the allergy with other parents and your child.

What is a peanut allergy?

A peanut allergy occurs when your body “produces a protein that’s directed towards the peanut protein, that triggers your body to have an allergic inflammation that leads to an allergic reaction,” Collins explains.

What is a peanut allergy test?

According to Collins, there are three ways to test for peanut allergies.

One of them is, well, to let your kids try to ingest some peanuts. Most of us hold this test in the lab known as our kitchen or dining room (which honestly, looks a little like a mad scientist lab when you have little babies lobbing food all over the place.) According to Cleveland Clinic, most kids should be exposed to peanuts and other allergens before age 1. Once you’re a few weeks into solids, you can mix some peanut butter into your baby’s purees. You should only do this after you’ve consulted with your child’s pediatrician about the safest way to introduce peanuts to your baby.

There are two other ways to test for a peanut allergy in a doctor’s office. One of them is through what doctors call a skin prick test. “A small amount of the protein is put on your arm or back and you’re pricked,” Collins explains.

Then, of course, there’s old fashioned bloodwork. What kid doesn’t love to have their blood drawn?! If you’re going for this, may we suggest a post-doctor visit treat —for mommy and child. You can test for allergies through a blood test called the RAST test or immunofluorescence test. The test checks the blood for antibodies that will indicate whether the person has an allergy.

Lee says that it’s important to remember that when it comes to allergy testing, you are only going to see results if the allergy is life-threatening.

What are peanut allergy symptoms?

Symptoms can vary greatly from patient to patient, according to Collins. “The symptoms of a reaction would be rash, maybe they have hives, nasal congestion, a runny nose, abdominal pains, some patients have nausea, or they actually throw up,” Collins says. “Other patients have difficulty breathing, things swell like their lips or tongue  some patients have throat swelling and could actually collapse from it.”

Anaphylaxis is the most serious allergic reaction to peanuts. It’s a severe allergic reaction that usually happens right after exposure to the allergen. If your child experiences anaphylaxis, you have to administer an epinephrine shot and call 9-1-1 to get them to the ER right away.

How do you treat a peanut allergy?

“The best practice right now is through avoidance of the peanut. There’s no cure for food allergies right now so avoidance is the best method. There are peanut allergy treatments that are being looked at currently for treatment or prevention of peanut allergies but nothing has been approved by the FDA,” according to Collins.

Lee agrees that right now, your only FDA approved course of action is avoidance, but she’s optimistic about future treatments for peanut allergies: “For peanut, we will hopefully have two FDA approved products of certainly increasing your tolerance threshold and maybe even desensitizing you — one is going to be a peanut patch and the other an oral immunotherapy treatment. So we obviously have a lot of hope in those products as well as some upcoming research.”

Are there different peanut allergy symptoms for babies?

According to Collins, symptoms don’t differ based on age. Though, parents’ reactions to allergic reactions may vary depending on the age of the allergic kid and their experience spotting and reacting to symptoms.

Can you outgrow a peanut allergy?

While some food allergies, like milk, can be outgrown, “typically, with a peanut allergy, most patients don’t outgrow it, [but] it certainly can change. It could change in severity or become milder,” Collins says.

However, according to Lee, “around 20 percent of people outgrow a peanut allergy,” which is statistically just way lower than many allergies, like egg or dairy. 

This can be confusing, so it’s always best to confer with a pediatric allergist, as they have a better understanding of your child’s medical history.

Are allergic reactions only a result of ingestion?

When it comes to what’s going to actually cause the allergy, as we’ve mentioned above, it’s the protein in the peanut. So the smell of peanut butter, while extremely powerful, will not cause an allergic reaction. Still, Lee says: “with peanut allergy, my biggest concern for food-allergic patients is ingestion.”

She adds, “Having a severe reaction is usually just going to come from the ingestion of the food.” But there are situations that may cause the peanut protein that causes allergic reactions to get into the air, like when you roast or boil peanuts.

You may have also noticed that most airlines are starting to ban peanut packets, there’s a reason for that: “When you open a peanut packet if you take a quick inhalation of that peanut dust in the air,” you can have an allergic reaction to the protein in that dust —though as Lee says, “that’s a very rare situation.”

What food should you avoid?

Giving one answer to this question is misleading, according to Collins. “Some people are just allergic to peanuts and don’t have to worry about other things but other people have other allergies along with the peanut allergy,” Collins explains. “That’s where really talking to an allergist can help guide you on how to introduce things,” Collins explains, “What to look for and the foods that may or may not cross-react with a peanut — what’s going on with the actual individual. It’s much more patient-directed.”

When do kids develop a peanut allergy?

While some babies may present allergic reactions at first exposure, starting at just a few months, it turns out that “you can develop an allergy at any point in your life.” According to Collins, “Peanut allergies typically present in childhood but you can present an allergy to peanuts at any point.” That’s right. You can develop a peanut allergy at any point in your life. 

When should you go to the doctor or allergist?

“I think any time anybody is having a reaction to a food they should see an allergist or a specialist that can help guide them,” Collins says. So don’t be afraid to take your kid to an allergist, even if you think their allergies are mild. “Sometimes the symptoms patients are experiencing is not a true allergy, so if you have access to an allergist it’s valuable to get an expert opinion,” Collins says. 

What are some common misconceptions about peanut allergies?

While peanut allergies are scary, “peanut allergies and food allergies are generally rising among the population for reasons that we’re not exactly 100 percent clear on,” according to Collins, they’re just not as common as we might think. “Oftentimes parents can be scared to introduce foods that, most of the time, do not cause an allergy. Certainly, the majority of people are not allergic to peanuts,” she says.

It used to be common practice to wait to introduce allergens like milk, fish, and peanuts, but nowadays, it is recommended to introduce them early. Especially for babies who are more likely to develop allergies, like babies with severe eczema, the recommended age of introduction is around 6 months. A 2015 NIAID study found that early exposure to peanuts “led to an 81 percent relative reduction in the subsequent development of peanut allergy.”

How do I talk to other parents and family about my child’s allergy?

Just let other parents know that your child has an allergy and what the severity of the allergy is. Be specific about what they can or can’t eat and what their sensitivity is. Some kids can’t be in a house with peanuts, for other it’s OK, as long as they don’t come into direct contact with peanuts. Be upfront with what precautions must be taken. Make sure that when your child is alone at a playdate or with family, that they have an anaphylaxis plan and that they are comfortable managing if there’s accidental exposure. That they know how to administer epinephrine or Benadryl if needed — and that they’re comfortable with doing that if it becomes necessary. Don’t assume that they have food for your child — bring snacks and other food items they might need.

How do I deal with communal snacks?

Snack time AKA a kid’s favorite time can be a little fraught when your little one has allergies. A good thing to do is to make sure they have appropriate snacks and that they have enough to share with others. “Children with food allergies often feel left out because they can’t have other people’s food,” Collins said. Bringing enough of an allergen-free snack so they can share with their peers “will help them feel less isolated.”

How do I talk to my child about their peanut allergy?

With all this talk of physical symptoms, which can be a big deal, it’s easy to overlook the fact that having an allergy can be a very emotional experience. For you, of course, but also for your kid. Some kids develop a sort of ‘PTSD,’ or “food anxiety where they’re scared to eat out of the home,” Collins tells Scary Mommy. “I think you have to be really careful with the words you use around children,” she says. “When you use words like anaphylaxis, I think that’s very scary for a young child.” Collins recommends getting some children’s books that explain allergies to kids.

She also suggests that instead of using scary medical terminology, which let’s face it, can freak adults out as well as children, you can tell your kid that peanuts “make you really sick and that you have to go to the doctor, and say ‘food makes you sick sometimes,’ that’s a good way to talk to your child because they already know what it’s like to be sick.” So it’s not something foreign and terrifying.

Most importantly, when speaking to younger kids, use simple, direct, and age-appropriate talking points like the following:

— You have a food allergy, and anything with peanuts can make you feel very sick. Use simple terms like “safe food’ and “unsafe food”.

— Don’t have food that has not been approved of by mommy or daddy.

— Tell us or your teacher if your tummy hurts, you don’t feel good, or feel funny.

— Teach them what foods will make them sick, pointing them out during a trip to the supermarket.

Parents can also turn to resources like books, videos, games, apps, and music that have been tailored to teach young kids about food allergies. For example, the American Academy of Allergy, Asthma and Immunology has created a Mr. Nose-It-All character to help children understand and identify their allergy and symptoms through play.

What are some good recipes for kids with peanut allergies?

There’s a lot of great recipes out there for kids with peanut allergies. You can find some on allergicliving.com, Eating Well and BBC’s Good Food.  We love this recipe for nut-free peanut butter chocolate chip cookies, because, yes your allergic kid deserves to enjoy this great cookie staple (and also, you deserve a cookie! Or two. Or three. Who’s counting?) And of course, how can we forget the perfect alternative for a peanut butter & jelly sandwich for kids with peanut allergies. You grew up on it and now you can raise your allergic kid on it too. Aw, nostalgia.

What are some good books for kids with peanut allergies?

There are some really great books out there that can help introduce your kids to allergies in an age-appropriate way. Talk to them about allergies using their favorite characters, like Daniel Tiger’s Daniel Has an Allergy, or The Bugabees: Friends with Food Allergies Other great books include The Princess and the Peanut Allergy, The Peanut-Free Cafe and Nutley: The Nut Free Squirrel. Because you can always count on kids’ books to make even the most terrifying things just so friggin’ adorable.

What’s the most important thing to do if your kid has a peanut allergy?

If you suspect your kid has a peanut allergy, Collins’s number one piece of advice is, well, to call an allergist. “There are allergists and immunologists across the country and they are highly trained to help with a lot of these issues and to provide really specific advice about food allergies. Having that conversation is really important. There are a lot of myths about food allergies,” so finding the right doctor and specialist to give you the right advice for your kids specific food allergy and help dispel those myths is of paramount importance.

How do I talk to other parents or party hosts about my child’s peanut allergy?

If you find you’re uncomfortable talking about your child’s peanut allergy to party hosts or other parents at your kid’s school, we’re here to say, STOP IT. Niceties fly right out the window when we’re talking about potentially life-threatening allergic reactions. Remember, you’re not making some outlandish special requests, you’re ensuring a safe space for your child.

The best mode of action is to keep the conversation direct, simple, and as far ahead of time as you can, so the hosts can make all the necessary preparations and adjustments. You might actually find this is not a big deal for other parents at your child’s school. In fact, with nearly all daycares and schools already peanut-free establishments, most parents are already taking extra precautions at playdates and birthday parties.

You might, however, need to offer some more information or handholding for any elderly relatives in the family. Per a CDC report, food allergies in kids has shot up by a stunning 50 percent between 1991 and 2011, meaning people with adult children might not quite understand how dangerous or prevalent food allergies might be. Don’t be nervous about giving them clarity on your child’s needs.

What are some resources for parents or children with food allergies?

If your child has food allergies, aside from your pediatrician and allergist, it may not always be clear where else you can turn for support. We recommend joining an online community of parents with your child’s specific allergy. There you can ask questions and be directed towards resources you may not have known existed. Parents can ask for advice on how to talk to young kids about allergens, share recipes, and even offer that extra bit of support.

Food allergy podcasts parents should check out

Conversations From The World of Allergy — The official podcast from AAAAI is a fantastic resource for parents navigating school, play, and their children’s allergies. With expert guests offering tips and advice, it’s not meant as individual medical advice, but as a guide. Per the podcast’s official website: “This podcast is not intended to provide any individual medical advice to our listeners. We do hope that our conversations provide evidence-based information.” All specific medical queries should obviously be addressed to your child’s allergist.

Exploring Food Allergy Families — This podcast touches on the realities of living with food allergies and its impact on the physical, mental, and emotional health of all involved. With tips and hacks offered by the show’s host and guests, it could serve as a helpful resource for parents.