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Nut Allergies

Information about Peanut Allergy
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Disclaimer: Information contained here is for general interest only. You should speak to your doctor or paediatrician about issues concerning your own baby.

  • Recent research discovered that about 1 in 200 children in a Western community had experienced a reaction to peanut prior to 5 years of age.
  • Approximately 3% of children show positive in a peanut allergy test (often a skin prick test), but thankfully,only 30% to 35% of these will develop reaction symptoms when they actually consume peanuts.
  • Any child who never eaten peanut, but has a positive allergy test will need a doctor to make further tests and give advice on the possibility of developing an allergy.
  • Allergy to peanuts in childhood differs from country to country -Australia, for instance, has a relatively high number of people with peanut allergy.
  • Severe reactions from casual contact (other children’s hands, sitting next to someone eating peanuts, or smelling peanuts, for example)are extremely rare.

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With peanut allergy,IgE allergy antibodies react against peanut proteins, and symptoms will occur soon after exposure to peanuts or any peanut products:

  • Mild reactions are hives (welts) – often around the mouth where peanut has touched the skin, or over other parts of the body.
  • Abdominal pain and vomiting may occur.
  • Coughing, wheezing, breathing difficulties or hoarseness of the voice indicate amore serious reaction occurring in the airway.
  • In very severe cases collapse and loss of consciousness can occur.
  • A rare, but extreme reaction that can affect a highly a sensitive individualis anaphylaxis – which is life threatening, and requires immediate medical help.

Diagnosis of peanut allergy…

  • In most cases, the first indication is the start of symptoms soon after exposure to a peanut product. The presence of IgE antibodies to peanut protein can be confirmed – usually with a skin prick test or a blood test (RAST test) – by a specialist.
  • Not every child with a positive allergy test will necessarily develop symptoms on exposure to peanut product, so the test should be discussed with your doctor, who may suggest a peanut food challenge under hospital supervision.

Avoiding exposure to peanut…

Peanuts and peanut products are sometimes found in foods that you would not expect them to be in, so be sure to read all food labels carefully, and avoid foods that list any of the following as ingredients:

  • Peanuts, ground nuts, beer nuts, monkey nuts.
  • Peanut oil – cold pressed, expressed, or expelled (this includes an oil called Arachis oil) -though highly refined peanut oil is unlikely to cause a reaction.
  • Crushed or ground peanut (often used in sauces such as satay and peanut sauce, or for coating foodslike cakes, buns and ice creams).
  • Any peanut product–for example, peanut butter.

Peanut or peanut products may be used in:

  • Cakes, biscuits, crackers, pastries and health bars (muesli bars, for example)
  • Chocolates, Turkish delight, marzipan, nougat and ice creams
  • Breakfast cereals
  • Hydrolysed or textured vegetable protein (HVP and TVP – usually soy)
  • Salad dressings
  • Soups and spaghetti sauces
  • Ethnic cooking, such as Chinese, Indonesian and Thai dishes

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Many food labels warn that the food “may contain traces of peanuts”. The food itself may not actually contain peanut, but it has been made in a facility makes other foods thatdo contain peanuts. Speak to a medical professional about these foods if your baby or anyone in your family has a peanut allergy.

Peanut oil…

  • Peanut allergy is caused by the protein, not the oil (fat), in the peanut.
  • Cold-pressed peanut oil does contain peanut protein, so it should be avoided.
  • It is difficult to guarantee that the peanut oil is sufficiently refined to remove all traces of peanut protein, so it is best to avoid all peanut oil – particularly for those who have had severe life-threatening reactions.

Other types of nuts…

  • Some children may have a reaction to different types of nuts, and allergy to different types of nut is oftenalso checked with skin prick tests.
  • Depending on your baby’s test results, type of reaction and family history, your doctor may advise you to avoid all types of nuts
  • It is possible for contamination to occur in facilities where different types of nuts are involved in processing.
  • Avoiding all nuts is the safest course of action, for those with sensitivities.

EpiPens and Anapens…

  • EpiPens and Anapens are emergency devices used to counteract a severe reaction to peanut (or other stimulus) by injecting a dose of adrenalin. The adrenaline reverses the reaction, and can be lifesaving.
  • Most parents and carers of a child who has had a serious reaction to peanut that involved the breathing passages are advised by experts to have an EpiPen or Anapen on hand at all times.
  • Your own doctor will advise you in the case of your own child.
  • If you are advised to keep an EpiPen or Anapen, it is extremely important that you understand how to use it, and you may need to carry a written Anaphylaxis Action Plan provided by your doctor.

Avoiding peanut allergy for your baby…

Some evidence does suggest that skin creams containing peanut product may actually prompt sensitisation, but nothing can guarantee that your baby will not develop an allergy to peanut – and there is no evidence that avoiding peanuts and peanut products during pregnancy, or when you are breastfeeding will prevent peanut allergy inyour baby.

According to some recent research, it is possible that the introduction of peanut-containing foods at an early stageduring infancy may protect against the development of peanut allergy -but your own baby’s doctor or paediatrician should be consulted about this.

Outgrowing a peanut allergy…

Sadly, most children (up to 80%) who develop peanut allergy under the age of 5 years will continue to be allergic into later childhood. Happily, though, up to 20% of children do eventually grow out of their allergy:

  • In nearly all cases where a child has grown out of peanut allergy, it does not come back.
  • Rare cases do occur where the allergy does return, but it is thought that this is more likely if peanuts and peanut products continue to be avoided after the allergy has been outgrown – for this reason your doctor may advise that your child is given peanut products several times a week.
  • Those who have had more severe allergic reactions, involving breathing problems, are much less likely to outgrow the allergy than those who have milder reactions, and allergy tests will usually be carried out every 12 months or so to monitor the situation.

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