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Peanut Allergy: What You Need to Know

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Updated May 16, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Pile of whole peanut pods on a wooden table
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Peanut allergies are the third most common food allergy for American children and the second most common for adults. About 0.6% of adults and 1.4% percent of children are allergic to peanuts.

No one knows why, but peanut allergies are becoming more common among children. The percentage of children with peanut allergies grew from 0.2% of children to the current rate of 1.4% of children between 1997 and 2008, according to a long-term study by researchers at Mount Sinai School of Medicine.

Boys have higher rates of peanut allergy than girls, and non-Hispanic African-American children have a higher rate of peanut allergy than children of other ethnicities.

Outgrowing Peanut Allergy

Unlike some of the other common childhood food allergies, peanut allergies are often lifelong. Only about 20% of children with peanut allergies will outgrow them by age 6. One study found that children who developed a tolerance of peanuts but who rarely ate them became allergic to peanuts again after several years.

Symptoms

Like other food allergies, the symptoms of peanut allergy usually show up immediately after eating peanuts or food containing peanut products. Symptoms may begin within a few minutes, but may take as long as two hours to appear.

An allergic reaction to peanuts may involve:

Peanuts are more likely to cause a severe, systemic allergic reaction called anaphylaxis than other major allergens. Anaphylaxis is a medical emergency and requires prompt treatment.

Managing Your Peanut Allergy

There is still no cure for peanut allergies, so managing your allergy involves strict avoidance of all peanut products and being prepared for possible reactions.  If you have been diagnosed with a peanut allergy, your doctor will prescribe an epinephrine auto-injector (commonly called an Epi-Pen) that you will need to carry with you at all times.

There are multiple research studies going on right now that are searching for a cure or treatment for peanut allergies. Most involve a desensitization to peanuts through eating microscopic amounts of peanut protein. Because of the risk of severe allergic reaction, none of these treatments is ready for your local doctor's office yet. Researchers also caution against trying to desensitize yourself at home.

Avoiding Peanuts

Peanuts are one of the eight most common food allergies in the United States, and are covered by the food allergy labeling law (FALCPA). Food manufacturers must list peanut ingredients on their labels in plain English. Some manufacturers will disclose if a product has been made on shared equipment with peanuts. However, they are not required to do so.

However, peanut ingredients may be hidden in restaurant food or no-food items:

  • Peanut oil is a common cooking oil, especially used in deep-frying and Chinese cooking. Refined peanut oil is considered safe for most people with peanut allergies, but cold-pressed oil may contain higher levels of peanut proteins.
  • Peanuts are often used in non-food items such as lotions or makeup.
  • Heating peanuts or peanut butter may release proteins into the air that can cause a reaction for some people.

Peanuts at school

Kids love peanut butter, and PB&J is a lunchbox staple. But because peanut oil is sticky, it can cross-contaminate other foods, or remain behind on lunch tables, hands, or drinking fountains. Schools have dealt with the risk of cross-contamination in different ways, from establishing separate lunch tables to banning peanuts from the entire school.

Cleaning peanut residue off hands and desks is relatively simple, but it does require a daily cleaning routine that some parents may resent. Balancing the needs of children with peanut allergies with the freedom of other children to eat their favorite foods can be challenging.

If your child has a peanut allergy, contact the school before the first day. Talk to the school nurse and teacher about ways to keep your child safe at school.

Cross-Reactivity

Peanuts are a legume, not a nut, but about one-third of children with a peanut allergy will also be allergic at least one type of tree nuts. The most common nuts are almonds and hazelnuts. A small percentage of children with peanut allergy may have an allergy to multiple legumes. The most common are soy, chickpeas, and lentils. There is also a known cross-reactivity between peanuts and lupine, a legume that is common in Mediterranean cooking but rare in the United States.

If you have a peanut allergy, you should not avoid these foods out of fear of developing an allergy to them. Avoiding foods limits your diet and may actually contribute to developing a sensitivity rather than prevent one. Talk to your doctor about which foods are safe for you.

Peanuts and Kissing

Because peanut butter sticks around, there have been people who have had reactions after kissing another person who has eaten peanuts. There is no way to wash the peanut protein out of one's mouth. Teenagers or adults who are dating should talk to their partners about their food allergy before kissing.

Flying with a Peanut Allergy

Many airlines now give out little packages of pretzels (or no snacks at all) instead of the classic airline peanuts. However, before you fly, research the allergy policies of the airline you intend to fly on. Some are more friendly to people with peanuts than others. Call ahead to book certain peanut-free flights or request a peanut-free meal.

Sources:

NIAID-Sponsored Expert Panel.Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel. The Journal of Allergy and Clinical Immunology. Volume 126, Issue 6, Supplement, Pages S1-S58, December 2010

Rate of Childhood Peanut Allergies More than Tripled Between 1997 and 2008. Mount Sinai School of Medicine, Jaffe Food Allergy Institute.

Scott H. Sicherer, MD, et al. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up.Volume 125, Issue 6, Pages 1322-1326 (June 2010)

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