By Kathryn Peck / Medically reviewed by Dr. Samantha Ball, DO
At 15 months old, my son was diagnosed with a peanut allergy. Two of my other children had dairy allergies, which they quickly outgrew, but a peanut allergy generated an amplified level of alarm for me because it is rarely outgrown and the risk of anaphylaxis that exposure may cause.
Once I weathered the emotional rollercoaster that this diagnosis offered (read “Food Allergies: That Emotional Trigger”), I began talking with doctors and other parents about managing peanut allergies in young children. After all, when the doctor casually mentioned an example of French Fries cooked in peanut oil, I realized there was a lot more to this allergy than simply avoiding peanut butter sandwiches. And because he’s too young to understand the importance of this diagnosis, I realized I needed to come up with an action plan to educate myself, my family and friends.
After all, when the doctor casually mentioned an example of French Fries cooked in peanut oil, I realized there was a lot more to this allergy than simply avoiding peanut butter sandwiches.
It’s all about avoid allergy trigger foods, right? But because of his young age, my little guy can’t speak for himself when it comes to his allergy triggers. So here are some items I put together, my action plan, to help us all get on the page in ensuring his safety.
Learn about reading food labels.
True, the federal Food Allergen Labeling and Consumer Protection Act (FALCPA) makes identifying problem foods easier, but it only covers the eight most common allergens: milk, egg, peanut, tree nuts, soy, wheat, fish and crustacean shellfish. My son has a peanut allergy, so this is a great place to start, as the FALCPA requires all packaged foods regulated by the FDA to clearly list “peanut” on the ingredient label if it contains peanuts.
There are three ways to locate a problem food on a food label:
- The allergen – in my case peanuts – may be listed in the ingredient name.
- The allergen may appear following the ingredient name in parentheses, which happens when the ingredient is a less common form of the allergen; i.e. albumin (egg).
- The allergen follows the word, “contains” in a statement following the list of ingredients.
Interestingly enough, warning labels such as “may contain peanut” or “made in a facility with peanut” are voluntary. This might be a nice touch on some labels, but it’s worth noting that the absence of an advisory label does not necessarily mean that a product is safe from allergen exposure. Suddenly things look a little more complicated, right?
Interestingly enough, warning labels such as “may contain peanut” or “made in a facility with peanut” are voluntary.
Other phrases like “peanut-free” and “egg-free” are not government regulated, either. Product labels can have these phrases on them but be made in facilities where the allergens are present.
Know your allergen inside & out.
Get as much information as you can about your allergen, including the foods it often appears in, common routes of cross-contamination, and other less-common names that they might be called.
People with a peanut allergy, for instance, are also advised to avoid foods that contain cold pressed, expeller pressed, or extruded peanut oil (different from highly refined peanut oil, which is generally considered safe). Other ingredients to avoid are artificial nuts, beer nuts, ground nuts, and monkey nuts to name a few. Many experts advise patients allergic to peanuts to avoid tree nuts as well, Mandelonas (aka the “fake nut”) are actually peanuts soaked in almond flavoring, and Arachic oil is another name for peanut oil.
Keep a list of foods to avoid + make copies for others.
There is a long list of ingredients found on labels that indicate the presence of peanut protein, many of which I’d never heard of nor can I pronounce, but having a complete list for my own reference and for other family members, teachers, and friends is irreplaceable.
I broke my list into two groups: absolute “no’s” and “general things to avoid.”
And on the back? I listed symptoms of a reaction and next steps if Epi-pen is needed.
Arachic oil (aka peanut oil) / Arachis / Arachis hypogaea
Artificial nuts / Beer nuts / Earth nuts / Monkey nuts
Cold pressed, extruded or expelled peanut oil
Goobers / Goober peas
Hydrolyzed peanut protein
Peanuts, peanut butter (incl. candy, chips)
Peanut flour / Peanut Paste / Peanut sauce
General Things to Avoid
Egg rolls, spring rolls
Tree nuts (until further tests): almonds, cashews, hazelnuts, pine nuts, pistachios
Reaction & Next Steps
Symptoms: usually starts within minutes of exposure and may include:
Shortness of breath, wheezing, light coughing
Hives or redness (particularly around his mouth)
Tingling or itching in the mouth or throat
Diarrhea, nausea, stomach cramps or vomiting
Severe reaction (anaphylaxis): swelling throat, trouble breathing, dizziness. Use the EpiPen, even if you aren’t sure, it’s ok to use. It won’t hurt otherwise. Always call 911 after.
Keep epinephrine & antihistamines on hand.
Always keep epinephrine (EpiPen or Auvi-Q) and preferred antihistamines on hand, and be sure your child’s school has these, too. Also be sure that family and friends are familiar with how to use an EpiPen.
Diphenhydramine, aka Benadryl, is a common antihistamine that comes to everyone’s mind when they think of allergy treatment, but it’s been noted that some doctors are moving away from recommending Benadryl and instead, focusing on antihistamines like cetirizine (Zyrtec) or loratadine (Claritin), because they are quicker and longer lasting. As always, talk to your pediatrician about these options and which one is best for you and your child.
Please note: This is for educational and informational purposes only and is not meant to substitute individual medical advice. For specific and individual advice, always talk to your doctor.
About the author: Kathryn is the owner of Bicycle Pie and mom of 4 little ones. Also a writer, editor, and former owner of one of Boston's premiere baby boutiques, she continues to write about motherhood, children's products, family life, and all other things that test our skills and patience as parents.
About the reviewer: Dr. Samantha Ball, DO, is a pediatrician, cat mom, and advocate for children’s overall health and wellness. She is continually focused on supporting families through all stages in a realistic and evidence-based way. In addition to practicing medicine in Georgia, she shares experiences and her perspectives on topics including parenting tips, mental and physical health, and how to navigate the unexpected challenges that come about when raising kids.
Photo credit: iStock.com/Mypurgatoryyears