Spring 2015 Health Link Online

HealthLink Online

Uniting Children, Parents, Caregivers, and Health Professionals

Peanut Allergy Update

Peanut Allergy Update

Managing peanut allergy is challenging for child care providers and families who use child care. Peanut butter and products that contain peanuts are among the easiest and most tasty lunch and snack foods. Peanut allergy only occurs in 1-4% of the population. However, reactions to peanuts can be severe.

In 2013, a Princeton researcher, Miranda Waggoner studied the emergence of what some have called an “epidemic” of peanut allergy. She found that the publicity about peanut allergy has overstated the risk significantly.

Peanuts are not nuts; they are legumes. They are related to peas and beans. They are flavorful and nutritious. Peanut butter is safely transported and stored without refrigeration, making it a good choice to carry between home and child care or on picnics.

Avoiding peanut products is difficult. Many foods contain peanut oil or ground peanut thickeners. Some commercial food manufacturers prepare foods with equipment used to prepare peanut-containing products too.

Some people avoid giving children peanuts or products containing peanuts thinking that restricting peanuts might prevent peanut allergy. It may be the opposite.  In February 2015, the American Academy of Pediatrics news magazine reported research that suggests feeding small amounts of peanut butter to young infants as soon as they are eating solid foods may prevent peanut allergy. At 5 years of age, only 3% of children who received peanut feedings became allergic to peanuts, while 17% of those who avoided peanut products developed peanut allergy. 

Even for children who have a strong family history of severe allergies to peanuts, little evidence exists for delaying introduction of peanut products to prevent a peanut allergy. Once an infant has had no problem with a few typical baby foods, the baby can have peanut butter as early as 6 months of age.

To give peanut butter to an infant, use just a very thin smear on a spoon until the child starts eating toast. Avoid a large chunk. It may cause choking. Do not give young children whole peanuts. They can block the air tubes. Whole or partially chewed peanuts inhaled into the lungs can cause a severe and possibly fatal chemical pneumonia. Avoid whole peanuts until at least 5-7 years of age. By then, they are OK as long as children chew them well.

If a child is truly allergic to peanuts, prevent sharing peanut containing food between children in the group. Clean surfaces including hands that might have peanut products on them. Use detergent to clean food surfaces. Be prepared with a set of epinephrine auto-injectors in case an allergic child does have symptoms like swelling of the lips, tongue or throat, or trouble breathing. Ask the child’s health care provider whether banning peanuts from areas used by the child or from the facility is necessary.

The good news is that 1 in 5 young children will outgrow a peanut allergy. The child’s pediatrician or allergist can perform tests to track whether a child's food allergies are going away.