Ravina Sewani

Nut allergy is usually caused by peanuts. Peanuts grow underground. Peanut allergy can sometimes trigger life-threatening reactions. The proteins found in nuts are considered dangerous by the body and in response the body triggers an immune reaction against those proteins. Peanut allergies generally stay on for life but in very rare cases, children may outgrow these allergies. Peanut allergies are severe hence even trace amounts of peanut could trigger an immune reaction posing a threat to your child.Nut allergies are also very rarely caused by tree nuts grown above ground. Common tree nuts are Almonds, Brazil nuts, Cashews, Hazelnuts, Macadamia nuts, Pecans, Pine nuts, Pistachio, Walnuts, etc. If your child has a nut allergy, it is advisable to consult your child’s paediatrician before giving him/her coconut based foods. This is because coconut belongs to tree nuts family. Symptoms:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis.</li></ul> Diagnosis:<ul><li>Always get the diagnosis done by an expert. The doctor may recommend that your child undertake tests like skin prick test, blood test or food challenge. It is important that these tests are performed under medical supervision as these tests might trigger an allergic reaction.</li><li>Your child may develop allergies if there is a history of allergies in your family.</li></ul> Precautions:<ul><li>Always keep a habit of reading the food labels for the ingredients.</li><li>It is advisable to avoid all kinds of nuts if your child has developed allergy to one of the nuts. This is because there are risks of cross-contact and even trace amount of the nut your child is allergic to can lead to severe allergic reactions. Consult your child’s paediatrician for the same.</li><li>Inform your child's school or caretakers of the nut allergy so that they have an emergency response kit or you can provide the emergency kit to the school.</li><li>Keep an anti-allergic medicine prescribed by your child’s paediatrician handy in case of mild triggers.</li></ul> Foods to avoid:<ul><li>Cross-contact is common in the case of nut allergy so always be careful of the foods your child consumes.</li><li>Be careful of the following foods as nuts could be a hidden ingredient in them:</li><li>Cereals, breakfast bars, snacks like crackers, cookies, cakes, pastries, energy or protein bars, pancakes, egg rolls</li><li>Beverages like flavoured hot chocolate, flavoured coffee</li><li>Desserts like ice creams, frozen yogurts, chocolates, candy, fudge</li><li>Cheese, butter or oil from tree nuts or other nuts</li><li>Even personal hygiene products like shampoos, lotions, perfumes, and soaps may contain extracts from nuts</li><li>Pet food, bird seeds, compost used as fertiliser may contain peanut shells</li></ul>

Nut allergies can be of two types: tree nut allergies or underground nut allergies.

Nut allergy

Peanut allergy triggers an immune response towards the proteins present in peanuts. It is one of the most common food allergies.Peanuts grow underground and are different from tree nuts.Please note that having a peanut allergy does not mean being allergic towards all nuts.Peanut allergy is usually developed in early childhood but can develop later in life as well. Diagnosis:Never self-assume that your child has peanut allergy. Always get your child diagnosed by a healthcare expert. The doctor may recommend that your child undertake tests like skin prick test, blood test or food challenge. It is important that these tests are performed under medical supervision as these tests might trigger an allergic reaction. Who is at risk?<ul><li>Family history: Your child has a higher risk of developing peanut allergy if it runs in your family.</li><li>Existing allergy: Having one food allergy may sometimes lead to some other food allergy to develop.</li></ul> Symptoms of peanut allergy:<ul><li>Itching</li><li>Rashes</li><li>Vomiting</li><li>Diarrhoea</li><li>Swelling of the lips or tongue or face</li><li>Throat constriction</li><li>Difficulty in breathing</li><li>Peanut allergy may sometimes also cause a life-threatening reaction called anaphylaxis which constricts the airway passage and requires immediate medical attention.</li></ul> Myths about peanut allergy:1. Myth: Peanut allergy is more common than other food allergies in children.Fact: No, Peanut allergy is not 'the' most common food allergy. Egg and milk are more common food allergies. 2. Myth: Peanut allergy is only developed in childhood and then stays on for life.Fact: Even though it is common in childhood, peanut allergy can develop at any age. A small percentage of children tend to outgrow peanut allergy but in most cases, it is permanent. 3. Myth: The allergic reaction develops immediately and of same intensity every time.Fact: In most cases, the reactions begin within minutes but in some cases, the allergic reaction might take a few hours as well. Also, the intensity of the allergic reaction is also not the same every time. 4. Myth: I can diagnose my child’s food allergies myself.Fact: While you can gauge your child’s allergic symptoms, they should always be diagnosed by healthcare expert. Commercial home test kits for self-diagnosis are not recommended as they may not be of the required standards. 5. Myth: If a dish or a food product does not list peanut, then it is safe.Fact: No, you must clarify and always pay close attention to the ingredients in a food product or a dish which is served to your child. Teach your child to develop the same practice as well. 6. Myth: Peanut allergy can be cured permanently.Fact: Researches are going on but there are no permanent cures for peanut allergy as of now. 7. Myth: Consumption of trace amounts of peanut-based food won't cause any problem.Fact: No, even a trace amount of peanut-based food can cause a severe reaction. Prevention:<ul><li>Studies suggest that if infants are introduced to peanut-based food then the chances of developing the allergy later are less. But such steps should always be taken under proper guidance of your child’s paediatrician.</li><li>Introducing peanuts in your baby’s diet:</li><li>If your child has any other food allergy already, it is better to first consult your child’s paediatrician and then introduce peanuts under doctor’s guidance.</li><li>You can introduce peanuts in your baby’s diet when your child starts eating solid food. Introduce peanuts in the form of a puree and not as whole. Observe for 10 to 30 minutes after feeding for any allergic reactions. If you find something wrong, consult your child’s paediatrician soon.</li></ul> Steps to take after reaction against peanuts get triggered:<ul><li>If your child has mistakenly consumed a food containing peanuts, the immune reaction gets triggered a few minutes to an hour.</li><li>The immune reaction varies every time and varies from child to child.</li><li>These immune reactions range from mild (itching or rashes) to severe life-threatening ones (breathing trouble or 'Anaphylaxis').</li><li>When your child shows mild reaction: Give your child doctor recommended medicines and take him/her to the doctor once your child starts feeling better.</li><li>When the reaction is severe: Give the medications recommended for such a condition as soon as possible and seek medical attention immediately.</li><li>Always keeps medications of allergies handy for your child.</li></ul> Therapies or treatments commonly used to treat peanut allergies:<ul><li>Antihistamine medicines for mild allergic reactions</li><li>Use Adrenaline auto-injectors (AAI) for severe allergic reaction like anaphylaxis. It is an injector pen that releases a prescribed dosage of adrenaline into the blood.</li><li>Always keep AAI handy because only AAIs can be used in treating severe cases of allergy reaction. Learn how to properly use an AAI on your child. These injector pens are usually used on the outer mid-thigh muscle.</li></ul> Following few alternative therapies are being tried as a long-term cure:<ul><li>Skin patch: It is a small adhesive patch which can be used topically on skin. It releases peanut proteins in small amounts into the blood. These are used to protect against accidental cases of exposure or consumption of peanuts.</li><li>Oral Immunotherapy (OIT): In this therapy, peanut protein based foods are given in small amounts to children known to have peanut allergy. Gradually the amount of such foods is progressively increased to develop tolerance against peanut proteins. Note: Do not go for this therapy without consulting your child’s paediatrician as this method can have serious consequences.</li></ul> Outgrowing peanut allergy:<ul><li>It is very rare that children would outgrow their peanut allergies as peanut allergies tend to stay on for life.</li><li>Peanut and other nut allergies:</li><li>Peanuts are legumes so it is rare that children with peanut allergy would develop allergies to tree nuts (eg. walnuts, almonds).</li><li>Sometimes, children with peanut allergies might develop allergies to other legumes like lupin or sesame.</li></ul> Foods to avoid or things to take care of if the child has peanut allergy:<ul><li>Develop a habit of reading the food labels for ingredients and allergy information.</li><li>Teach your child to mention about the allergy whenever he/she goes to visit someone.</li><li>Be careful about the possibility of cross-contact; especially when visiting a restaurant.</li></ul> Check the labels/ingredients of:<ul><li>Ice creams, candy, nougat, pancakes, egg rolls, and salad dressing</li><li>Sauces such as pesto, gravy, chilli / hot sauce, and enchilada sauce</li><li>If there is equipment sharing between peanuts and other nuts, be careful about the same.</li><li>Food or drinks such as hot chocolate, cookies, pudding, pies or other baked foods</li><li>Vegetarian food labelled as meat substitutes</li><li>Pet food (cross-contact risk) or compost used as fertiliser may also contain peanut shells (cross-contact risk).</li></ul>

Peanut allergies tend to stay on for life so it is very important to stay conscious and aware all the time.

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