Peanuts are actually legumes, like beans or peas. They differ from the “tree nuts,” like cashew and hazel nut, which grow on trees.
Peanut allergy has increased impressively over the past few decades so that in most countries, 1:50 to 1:100 children have a peanut allergy. This is a major public health concern. Peanut is one of the most common causes of anaphylaxis in children.
Most people who react to peanut react in an immediate type fashion, with symptoms such as hives, vomiting or even respiratory distress. Reactions to peanut may be unpredictable: a mild initial reaction does not necessarily mean the next reaction will be as mild. Unfortunately, peanut allergy is only outgrown in about 20% of cases.
Peanut allergy sufferers have an increased risk of egg, tree nut, legume and sesame seed allergies. These associated allergies should be specifically asked for by your doctor and investigated if you are not sure whether your child has tolerated these in the past or not.
The current evidence supports investigating the patient to find out exactly which nuts they are or are not allergic to, rather than “blanket” exclusion of all nuts. The idea is to include those nuts which the patient is not allergic to in the diet regularly to try and avoid the development of further allergies to nuts.
If a peanut allergy has been diagnosed, it is imperative to have an action plan and easy access to emergency medications. Ensure that the school is aware of the peanut allergy and is assisted in becoming “allergy aware”. This may require input by your allergist.
The process of “desensitization” to peanut (also known as “specific oral tolerance induction”) has moved from a research tool into allergy practice. This involves the concept of giving tiny, and gradually increasing, amounts of peanut protein on a daily basis to carefully selected peanut allergy sufferers, under the direction and care of your allergist. In this way the body slowly becomes “used” to peanut and eventually becomes desensitized.
However, this does not necessarily mean permanently outgrowing the peanut allergy. The patient may still react, especially if there are “gaps” in taking the peanut regularly, but the idea is to increase the threshold so that patients do not react as easily to small, contaminating amounts of peanut protein.
For some patients, this can really improve their quality of life. For others, the side effects experienced during the process may lead them to discontinue and rather avoid peanut.
Certainly this is an exciting new area of allergy management which should be discussed with your allergist.