Kids Health Info

Peanut and tree nut allergy

  • Peanut allergy is a common allergy in Australia. As many as one child in 200 could have a peanut allergy. An allergy can develop at any age, even in adulthood. About one person in 10 with a peanut allergy will become 'non-allergic' over time.

    Peanut allergies are more common in people who have other allergic conditions such as hay fever, asthma and eczema. They may also have allergies to other foods such as milk, eggs, shellfish and other nuts. It is important to find out what else your child might be allergic to.

    Signs and symptoms

    Most people's reactions to peanuts are mild. The most common symptoms can include hives (rash and itching on the skin), extra eczema and vomiting. Severe symptoms are more uncommon. They include difficulty breathing due to swelling of the mouth and throat. If this happens, the person needs to have urgent medical help.  Call 000 for an ambulance or go straight to the nearest hospital emergency department.

    Treatment and diagnosis

    The only real treatment for peanut allergy is to avoid peanuts completely. Peanuts are hard to avoid because many foods are made in factories that may have used peanuts or nuts in other foods. Even in tiny amounts, peanuts and nuts can cause symptoms. 

    If you/your child has a diagnosed severe allergic reaction (anaphylaxis) to peanuts, then they may need to have an EpiPen (an automatic device for giving adrenalin - medication for anaphylaxis).

    If your child has a reaction to peanuts and other nuts, a doctor will need to ask you a series of questions to find the cause of the allergy. For example, they will ask you what foods your child eats, if your child takes any medicines, and if your child may have come into contact with any stinging insects.

    By answering these questions, you can help to rule out other conditions that can sometimes be confused with food allergies. 

    If your child does have a possible peanut allergy they will need a blood test, called a RAST allergy test, or a skin prick test. This test may be needed to test your child's allergies to other foods too.

    At home

    Foods to avoid

    Peanuts are hard to avoid because they are used widely in processed western and Asian foods. It is law that any product which may contain peanuts or even tiny amounts of peanuts must include that information on the food labelling. Some manufacturers will label their products as possibly containing traces of nuts. Sometimes, nut products or oils have been used as unlabelled ingredients in cosmetics such as massage oils.

    • People with a peanut allergy should avoid all nuts. Nuts from trees like walnuts, almonds, pecans, pistachios or cashews carry a risk for anyone who is allergic to peanuts.  
    • Refined peanut oils (not cold pressed) have been shown to be safer. However, it is difficult to guarantee the oil is sufficiently refined and all traces of the peanut have been removed. This particularly applies to restaurants which use peanut oil for cooking.  In general, it is safest to avoid all peanut oils.
    • Arachis hypogaea is the scientific name for peanut.

    At school and childcare

    Organise a meeting with staff caring for your child at their school, kindergarten or childcare centre.  Staff will work with you to develop a management plan for your child, detailing the risks and how they will manage these on a day to day basis.

    • Your child should take their own nut free food with them to school. They should know never to swap food with other children. 
    • The staff in daycare centres and kindergartens where eating and food preparation is in a communal area must be told if your child has a severe peanut allergy.
    • Make sure that anyone caring for your child understands that absolutely no peanut products are to be given to your child. If you are not sure about the contents of a product ask your family doctor, MCHN or immunology/allergy doctor.

    Food that may contain peanuts

    RCH KHI Peanut allergies table

    Follow-up

    There are many health care professionals that are trained in allergy management. Once allergy testing is complete an action plan will be developed.  If needed, you will be educated about how to use an EpiPen. Avoiding peanuts is the only treatment. Future allergy testing may be done to see if the allergy is still present and if so, how serious it is. 

    Key points to remember

    • Peanut allergy is most common in infants but can develop at any age.
    • Often there are other food allergies.
    • Symptoms can be mild or severe.
    • Your child should see an allergy specialist if they have had a severe or anaphylactic reaction.
    • Medical staff will develop an action plan with you. Make sure you understand it well and ask if there is anything you're not confident about.
    • Always check labels of processed foods for traces of any peanuts or nuts.
    • Educate your child to never swap their food. 

    More information

     

    Produced in consultation with the RCH Dept Allergy, Immunology and Australasian Society of Clinical Immunology and Allergy (ASCIA).  First published Sept 2006. Updated September 2012.


Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.