When Your Child Has a Food Allergy: Peanut

When a child has a peanut allergy, any contact with peanuts may cause a life-threatening reaction. For that reason, your child must stay away from peanuts and anything that contains them. Some children also need to stay away from tree nuts, such as almonds, cashews, and walnuts. Ask your child's healthcare provider if your child should stay away from tree nuts, too. This sheet tells you more about your child’s peanut allergy. You’ll learn what foods your child should stay away from. You'll also learn what to look for on food labels and how to prevent cross contact. Cross contact means that peanuts accidentally come in contact with foods your child could otherwise safely eat.

Peanut allergy: foods to stay away from

Read every label for peanuts. Also tell every restaurant that you go to with your child about your child's allergy. Many foods can have hidden peanuts. Take special precautions with these foods:

• African, Chinese, Indian, Thai, Mexican, or Vietnamese cuisine. These often contain peanuts or have been in contact with peanuts.

• Bakery cakes, cookies, muffins, pies, and sweet rolls. Even if they don’t have peanuts in them, they may have had contact with peanuts.

• Prepared chili and pasta sauce. These may use peanut butter or peanut flour as thickener.

• Chocolate candies. These are often in contact with peanuts. Call the food maker’s toll-free number listed on the package for more information.

• Crushed nuts in sauces or sprinkled on salads and other foods

• Granola, muesli, trail mix, and energy bars. These may contain peanuts, peanut flour, or peanut oil.

• Ice cream and frozen yogurt. These may have had contact with peanuts.

• Mixed nuts, artificial nuts, and nut pieces

• Peanut butter and peanut flour

• Pesto. This is an Italian sauce that often contains nuts.

• Praline, marzipan, and nougat

• Some prepared salad dressings

• Worcestershire sauce and bouillon

What to look for on labels

U.S. manufacturers of packaged food items must state clearly on the label if it contains peanuts. Always read the whole ingredient label to look for peanuts. Peanut ingredients may be within the list of the ingredients. Or peanuts could be listed in a “contains peanuts" statement under the list of ingredients.

Foods that don't contain peanuts could be contaminated during manufacturing. Unfortunately, labels like "processed in a facility that also processed peanuts" or "made on shared equipment" are not regulated by the FDA. They are voluntary. Talk with your child’s healthcare provider about whether your child may eat products with these labels or if your child should stay away from them.

Some foods and products don't have to state that they contain peanuts. These include:

• Foods not regulated by the FDA

• Cosmetics and personal care items

• Prescription and over-the-counter medicines and supplements

• Toys and crafts

• Pet food

Treatment

A medicine is now available to treat peanut allergy in children. The FDA-approved medicine is for children and teens ages 4 to 17. A child with a confirmed peanut allergy can start taking the medicine at age 4. Talk with your child’s healthcare provider to find out if this medicine can help your child. If your child is taking this medicine, continue to make sure they don’t eat any peanuts or peanut products.

Preventing accidental exposure to peanuts

Food exposure

• Take special care in Asian and buffet restaurants, bakeries, and ice cream parlors where cross contact is likely.

• Don't let your child eat baked goods that you don’t make yourself.

• Use a “chef card” in restaurants. This special card explains your child’s allergy to restaurant workers. You can make your own card or print one from a website.

• When eating out, always tell restaurant workers about your child's food allergies. Do this even if your child has eaten there in the past.

• Fried foods may be cooked in peanut oil. Always ask at restaurants. Also ask your child's healthcare provider if your child needs to stay away from highly refined peanut oil.

• Pack your child’s lunch and explain why they should never trade food. If your child attends school, alert teachers, the school nurse, and appropriate cafeteria staff about your child's peanut allergy.

• Bring safe snacks and desserts to parties and outings.

• Talk with adults who spend time with your child. These include caregivers, teachers, and other parents. Ask them not to serve foods made with peanuts or other nuts.

• If you’re unsure whether a food is peanut-free, don't let your child eat it! Check the food maker’s website or call the toll-free number on the package.

Household exposure

Some children are more sensitive to peanuts than others. Certain children may react only to peanuts they eat. Other children can become very sick just from touching a peanut or inhaling its dust. Some families choose to make their house peanut free. Others don't. Talk with your child's healthcare provider about this issue. Ask them how to best protect your child. Keep in mind that peanuts are sometimes found in unexpected places. These include:

• Ant traps and mouse traps

• Bird food, dog food, hamster food, and livestock feed

• Some skin creams, shampoos, and hair care products

• Foot bags and beanbags. These may be filled with crushed nut shells.

Create a safety plan

• Always carry 2 epinephrine auto-injectors. Make sure you and those close to your child know how to use them.

• Have your child wear a medical alert bracelet or necklace with their allergy information.

• If your child doesn’t have epinephrine auto-injectors, talk with your child’s healthcare provider to see if you should carry them.

• Talk with your child's healthcare provider about making an anaphylaxis (life-threatening allergic reaction) action plan. This is used in case of an accidental exposure to peanuts. Go over this plan with everyone who cares for your child.

• Work with your child's school staff, teachers, and school nurse to make sure that staff education is provided, and a safety plan is in place. This must include people who can respond in an emergency.

If your child has ANY of the symptoms listed below, act quickly!

Use an epinephrine auto-injector right away if one has been prescribed. Then call 911.

• Trouble breathing, wheezing, or cough that won’t stop

• Swelling of the mouth or face

• Tightness in throat or hoarse voice

• Dizziness, confusion, or fainting

• Vomiting, belly pain, or severe diarrhea

Many areas of ongoing research focus on understanding allergies and allergic reactions. Talk with your child's healthcare provider often to find out about new research findings that may help your child.