Peanut allergy factsheet

Introduction

Peanut allergy is one of the most common and severe allergies in children. In Australia, almost 3% of children aged one year have a peanut allergy.

Children who are allergic to peanuts are not always allergic to tree nuts.

Peanuts are not real nuts. They are a type of plant called a legume which grows underground. Some children who have peanut allergies can also be allergic to other legumes, including lupin.

Peanut allergies can develop at any time from 6 months of age throughout your child’s life. They can become more severe as your child grows, and only a small number of children with mild reactions will outgrow the allergy.

Some children are more at risk of having a peanut allergy.

Risk factors include:

a family history of allergies and asthma
having eczema
having other allergies.

Signs and symptoms

Allergic reactions can be fast and happen within minutes of exposure to peanuts.

Reactions can include:

hives or welts on the skin
redness of the skin
vomiting and stomach ache
tingling and swelling of the mouth, lips, face, and eyes.

Some children can have a more severe allergic reaction called anaphylaxis.

Signs of anaphylaxis include:

wheezing, difficult, or noisy breathing
swelling of the tongue
swelling or tightness in the throat
a persistent cough
difficulty talking or a hoarse voice
dizziness
becoming pale and floppy in young children
collapsing.

If your child has signs of anaphylaxis, you should:

follow your child’s ASCIA action plan for anaphylaxis if you have one
use an EpiPen® or Anapen®, if there is one available
call Triple Zero (000) for an ambulance.

Some children can develop a delayed reaction that takes hours or days. Symptoms of a delayed reaction can include:

vomiting and nausea
abdominal pain or stomach ache
bloating
diarrhoea.

See your local doctor as soon as possible if your child is showing signs of an allergic reaction for the first time. Symptoms of mild allergic reactions should fade over time.

See your local doctor as soon as possible if symptoms do not get better or you are concerned.

Diagnosis

If you think your child has had an allergic reaction that is not anaphylaxis, write down the following and see your local doctor as soon as possible:

time the peanut was eaten
time of reaction
type of reaction
amount of peanut eaten
how it was prepared - for example, eaten whole, as peanut butter or in chocolate.

A specialist doctor can diagnose a peanut allergy based on your child’s:

medical history
signs and symptoms
results from allergy tests.

A food challenge can be done to figure out whether your child has grown out of their allergy and whether peanuts can be reintroduced to their diet safely. Food challenges are done under the supervision of a doctor in the hospital.

Treatment

Your child's doctor will find the best possible treatment for their allergy based on their individual health needs. In most cases, your child must carefully avoid contact with peanuts and peanuts in their diet.

Children at risk of anaphylaxis need:

an ASCIA action plan
an adrenaline injector, also known as an EpiPen® or Anapen®.

Your child will also need to learn how to identify foods that contain peanuts as they get older and become more independent with their diet.

Management

Common sources of peanuts

Peanuts are a common ingredient in food and can be difficult to avoid.

Some foods will visibly contain peanuts, for example, peanut butter, satay sauce and peanut brittle.

They can also be in other foods like:

baked goods - for example, cake, muffins, and biscuits
desserts - for example, chikki or Indian peanut sweets, chocolate, ice-cream, and nougat
breakfast cereals, muesli, and granola
dips, sauces, spreads, and marinades - for example, satay, Thai sauces, and nut butters.

Peanuts and peanut oils are also common in dishes like noodles, curry, stir-fries, and fried rice.

Peanuts, food labels and eating out

It is important to always check the package and ingredient list of all foods your child eats.

In Australia, allergens are shown in bold each time they appear in an ingredient list. Packaged foods may have a warning on the label that "may contain traces of peanuts".

This means the food is made in a facility that also makes foods that contain peanuts.

Talk to your child’s doctor about whether these foods are safe.

Always tell the staff that your child has a peanut allergy when eating out. This will help you find safe foods and avoid contamination.

If you cannot confirm that food does not contain peanuts, it is safest for your child to avoid it.

Education

The most important thing you can do is support your child in avoiding peanuts in their diet. You can also educate your child, family, and friends about allergies, reactions, and what to do in an emergency.

Parents of younger children will need to read ingredient lists and learn to find peanuts in foods and drinks.

Older children can be supported in learning to read ingredient lists and find peanuts in foods.

This can help keep children safe and encourage them to be more independent and confident about their diet and health as they grow.