Types Of Food Allergies
Food allergies are divided into 3 types, depending on symptoms and when they occur.
- IgE-mediated food allergy the most common type, triggered by the immune system producing an antibody called immunoglobulin E . Symptoms occur a few seconds or minutes after eating. There’s a greater risk of anaphylaxis with this type of allergy.
- non-IgE-mediated food allergy these allergic reactions aren’t caused by immunoglobulin E, but by other cells in the immune system. This type of allergy is often difficult to diagnose as symptoms take much longer to develop .
- mixed IgE and non-IgE-mediated food allergies some people may experience symptoms from both types.
Read more information about the symptoms of a food allergy.
How Can I Take Care Of Myself If I Have A Peanut Allergy
If you have a peanut allergy, you need to pay close attention to what you eat. Food manufacturers must clearly state on their ingredient label whether a food contains peanuts.
Prepackaged foods that dont contain peanuts can be contaminated during the manufacturing process. Watch for phrases like may contain peanuts and made in a factory on machinery that also may have been used to process peanut products.
When you go out to eat, ask questions about ingredients. For example, peanut butter may be in certain marinades or sauces. Ice cream or yogurt shops could be places of accidental exposure because peanuts are common ice cream toppings.
Why Are Food Allergies Increasing
The Centers for Disease Control and Prevention have reported a 50 percent increase in the number of children with food allergies since the late 1990s. Many theories have been suggested as to why the number of people with food allergies is growing, but scientific research has not yet found the cause.
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What Symptoms Might Be Harder To Detect
Most of us are familiar with the most common signs of nut allergies. But at times, the signs of a nut allergy might be more subtle.
Stomach aches or sleepiness in children who are not yet able to speak or describe their symptoms may be overlooked, says Dr. Owens. Dr. Leeds explains that some less obvious signs of allergic reactions may include feelings of confusion, or an impending sense of doom.
Several Ways To Come In Contact
Most people who are allergic have trouble when they have direct contact with peanuts — whether eating them by accident or not realizing they are part of a salad or recipe.
It can also happen through skin contact or by breathing in peanut dust or eating something made with gourmet or unrefined peanut oil.
But did you know that if you are very sensitive, indirect contact can trigger a reaction?
Its called cross-contact. For instance, a chef might be making a meal for you. It contains no peanuts, but they may have used their knife for an earlier task. If the knife touched peanuts and wasnt washed well, trace pieces could get into your dish.
Make sure any restaurant or dinner host is aware and taking care to avoid cross-contact.
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What Problems Can Peanuts Cause
Symptoms of an allergic response to peanuts will usually start within minutes of exposure, and they can include:
- Tightening in the throat
- Shortness of breath or wheezing
- Skin reaction such as hives or redness
- Tingling or itching in the mouth or throat
- Diarrhea, nausea, stomachcramps or vomiting
- A runny nose
How Common Is Nut Allergy And Who Gets It
In the UK about 2 in 100 children and about 1 in 200 adults have an allergy to nuts. The number of people with peanut allergy is growing.
Nut allergy is the most common type of severe food allergy. It often starts when children are very young. Most first allergic reactions take place when a child is between 14 months and two years old. Unlike other food allergies such as milk allergy, nut allergy is something that you are unlikely to grow out of. Only about 1 in 5 people with a nut allergy will grow out of it, and these tend to be the people who have mild reactions.
If you have what is called atopy, or if atopy runs in your family, then you are more at risk of developing an allergy to nuts. Atopy is the name for a group of allergic conditions that include hay fever, asthma and eczema. In particular, children who have eczema are more likely to develop a nut allergy. If you have an allergy to peanuts then you may also react to tree nuts.
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How Soon Would An Allergic Reaction Start
Symptoms of an allergic reaction usually develop within a few minutes of being exposed to something youre allergic to, although occasionally they can develop gradually over a few hours. Although allergic reactions can be a nuisance and hamper your normal activities, most are mild.
What Might Milder Reactions Look Like
A more mild allergic reaction to nuts may look like an itchy or runny nose, an itchy mouth, sneezing, and mild tummy pain, says Dr. Leeds. Your child may be showing signs of a milder allergic reaction when they have a few scattered hives, explains Dr. Owens. Or they may have swelling of just one side of their lip.
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How To Safely Introduce Peanut Products To Your Child
After your baby is already eating other solid foods, you can safely introduce age-appropriate peanut-containing foods at 4 to 6 months, unless your child is at high risk.
High-risk children are those who have severe eczema, an egg allergy or both. In these cases, your child should be screened by a healthcare provider. That provider may complete a skin or blood test first to measure your childs reaction to tiny amounts of peanut products.
If your child has mild or moderate eczema, you may feel more comfortable asking your primary care provider before you introduce peanut-containing foods.
For babies at no risk: Bring on the peanut-containing foods just not a whole nut, as it can be a choking hazard. Read these instructions created by the expert panel.
When Do Peanut Allergies Usually Develop
Around 80 percent of children who are allergic to peanut have a reaction on their first known exposure. However, to become allergic, kids have to be exposed to the allergen in some way first, by unknowingly eating it, being exposed through broken skin or coming in contact with it in other ways that are not yet well understood by experts.
Babies can even have a reaction to peanut proteins in breastmilk, though its very rare. One study found that peanut proteins showed up in the breastmilk of about half of women who ate half a cup of dry-roasted peanuts. The proteins were present about one to three hours after the women ate peanuts and quickly cleared from their milk.
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What Will The Doctor Do
If your doctor thinks you might have a nut or peanut allergy, he or she will probably send you to see a doctor who specializes in allergies. The will ask you about past reactions and how long it takes between eating the nut or peanut and getting the symptoms, such as hives.
The allergist may also ask whether anyone else in your family has allergies or other allergy conditions, such as eczema or asthma. Researchers aren’t sure why some people have food allergies and others don’t, but they sometimes run in families.
The allergist may also want to do a skin test. This is a way of seeing how your body reacts to a very small amount of the nut that is giving you trouble. The allergist will use a liquid extract of the nut that seems to be causing you symptoms.
During skin testing, a little scratch on your skin is made . That’s how just a little of the liquid nut gets into your skin. If you get a reddish, itchy, raised spot, it shows that you may be allergic to that food or substance.
Skin tests are the best test for food allergies, but if more information is needed, the doctor may also order a blood test. At the lab, the blood will be mixed with some of the food or substance you may be allergic to and checked for antibodies.
How Do You Diagnose A Peanut Allergy
If your child has a reaction after eating peanut, a skin prick test, a blood test or both will be done by an allergist to confirm the diagnosis. During a skin prick test, your childs skin is exposed to the allergen to see how big of a weal develops. The larger the wheal, the more likely it is that your child is allergic. Tests are usually repeated at follow-up appointments, every six months to every few years, to see if the child has developed a tolerance.
An oral food challenge, during which the child consumes peanut under the supervision of a doctor, may also be offered. The oral food challenge is the gold standard diagnostic test, says Kim. However, its usually only offered if the child has less than a 50 percent chance of reacting, which is based on their skin and blood tests.
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Reach For The Epinephrine
Many people with diagnosed severe allergies will receive a prescription for an epinephrine autoinjector from their doctor. If you are carrying your autoinjector when you begin experiencing the reaction, give yourself an injection right away. If youre too weak to give the injection, ask someone who is trained to administer it.
Its important to keep in mind that this medicine is a timesaver, not a lifesaver. Even after an injection, you must seek emergency treatment. Call 911 as soon as you inject the epinephrine, or have someone drive you to a hospital immediately.
What Else Should I Know
To help reduce contact with nut allergens and the possibility of reactions in someone with a peanut or tree nut allergy:
- If you keep peanuts and nuts in your home, watch for cross-contamination that can happen with utensils and cookware. For example, make sure the knife you use to make peanut butter sandwiches is not used in preparing food for a child with a nut allergy, and that nut breads are not toasted in the same toaster as other breads.
- Don’t serve cooked foods you didn’t make yourself, or anything with an unknown list of ingredients.
- Tell everyone who handles the food your child eats, from waiters and waitresses to the cafeteria staff at school, about the allergy. If the manager or owner of a restaurant is uncomfortable about your request for peanut- or nut-free food preparation, don’t eat there.
- Consider making your child’s school lunches, as well as snacks and treats to take to parties, play dates, sleepovers, school events, and other outings.
- Work with the childcare supervisor or school principal to make sure the food allergy emergency action plan provided by your allergist is followed correctly.
- Keep epinephrine accessible at all times not in the glove compartment of your car, but with you. Seconds count during an anaphylaxis episode.
A little preparation and prevention can help make sure that your child’s allergy doesn’t get in the way of a happy, healthy everyday life.
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What Is Food Intolerance
A food intolerance isn’t the same as a food allergy.
People with food intolerance may have symptoms such as diarrhoea, bloating and stomach cramps. This may be caused by difficulties digesting certain substances, such as lactose. However, no allergic reaction takes place.
Important differences between a food allergy and a food intolerance include:
- the symptoms of a food intolerance usually occur several hours after eating the food
- you need to eat a larger amount of food to trigger an intolerance than an allergy
- a food intolerance is never life threatening, unlike an allergy
Read more about food intolerance.
Page last reviewed: 15 April 2019 Next review due: 15 April 2022
When To Seek Medical Advice
If you think you or your child may have a food allergy, it’s very important to ask for a professional diagnosis from your GP. They can then refer you to an allergy clinic if appropriate.
Many parents mistakenly assume their child has a food allergy when their symptoms are actually caused by a completely different condition.
Commercial allergy testing kits are available, but using them isn’t recommended. Many kits are based on unsound scientific principles. Even if they are reliable, you should have the results looked at by a health professional.
Read more about diagnosing food allergies.
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What Causes Nut Allergy
If you are allergic to nuts, when you first come into contact with nuts your immune system reacts and prepares to fight. However, you don’t get any symptoms of a reaction. It is only when you come into contact with nuts for a second time that a full allergic reaction happens. Most children who are allergic to nuts have the symptoms of an allergic reaction when they appear to be exposed to nuts for the first time. However, this is probably not their first exposure, but their second. They may already have come into contact with nuts through their mother, through either of the following:
- Whilst they were in the womb .
- Through breast milk if they were breast-fed.
Most people with nut allergy react after contact with small amounts and some people may react to trace amounts. This means that you don’t always have to eat nuts to have a reaction. A few people are so sensitive to nut allergens that a tiny amount on their lips, or even standing next to someone eating peanuts, can be enough to start a reaction.
There are lots of different allergens but nuts cause some of the strongest and most severe reactions. Doctors don’t yet know why this is.
Suggested Procedure For Introduction Of Peanut Before 12 Months When The Infant Is Developmentally Ready For Solid Food
- Rub a small amount of smooth peanut butter/paste on the inside of the infant’s lip .
- If there is no allergic reaction after a few minutes, feed the infant ¼ teaspoon of smooth peanut butter/paste and observe for 30 minutes.
- If there is no allergic reaction, give ½ teaspoon of smooth peanut butter/paste and observe for a further 30 minutes.
- If there is no allergic reaction, parents should continue to include peanut in their infants diet in gradually increasing amounts at least weekly, as it is important to continue to feed peanut to the infant as a part of a varied diet.
- If there is an allergic reaction at any step, stop feeding peanut to the infant and seek medical advice .
- An allergic reaction should be treated by following the ASCIA Action plan: www.allergy.org.au/hp/ascia-plans-action-and-treatment – Mild or moderate allergic reactions can be treated using non-sedating antihistamines such as cetirizine, loratadine or desloratidine. To avoid confusion with the symptoms of anaphylaxis, sedating antihistamines should not be used to treat allergic reactions.- If there are symptoms of anaphylaxis treat with adrenaline and call an ambulance immediately.
- If an infant has an allergic reaction they may be referred to a clinical immunology/allergy specialist for further investigations: www.allergy.org.au/patients/locate-a-specialist
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Is There A Cure For Peanut Allergies
There is no cure for peanut allergies. But children can outgrow peanut allergies. As children get older, an allergist may perform another blood or skin test to measure a childs sensitivity to peanuts. If a peanut allergy appears to be decreasing, allergists may recommend an oral food test.
There are new treatments available called Oral Immunotherapy and early OIT. This is where carefully selected patients undergo therapy to help develop a tolerance to the food they have an allergy to. Palforzia®, a treatment for peanut allergies, is the first FDA approved treatment for food allergies. Although it doesn’t cure peanut allergies, it can make it possible for people to tolerate accidental peanut exposure without having a reaction.
If your child has a peanut allergy, it’s important to not give your child peanuts unless an allergist has directed you to do so.
As an adult, you can manage a peanut allergy by carefully avoiding peanuts. You may need to carry epinephrine if you have severe allergies that could lead to anaphylaxis.
What Are Peanut And Tree Nut Allergies
Peanuts are among the most common allergy-causing foods, and they often find their way into things you wouldn’t expect. Take chili, for example: It may be thickened with ground peanuts.
Peanuts aren’t actually a true nut they’re a legume . But the proteins in peanuts are similar in structure to those in tree nuts. For this reason, people who are allergic to peanuts can also be allergic to tree nuts, such as almonds, Brazil nuts, walnuts, hazelnuts, macadamia nuts, pistachios, pecans, and cashews.
Sometimes people outgrow some food allergies over time , but peanut and tree nut allergies are lifelong in many people.
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New Research: Introduce Peanut Early For Peanut Allergy Prevention
In 2008, Dr. Gideon Lack and others observed that Israeli babies developed peanut allergies much less frequently than babies in the UK. In fact, the rate of peanut allergy prevalence in the UK was ten times greater than the peanut allergy prevalence in Israel. He noticed that Israeli babies started eating peanut in their first year of life, but the babies in the UK didnt eat peanut for several years. This prompted Dr. Lack to conduct further research on peanut introduction and peanut allergy prevention.
The landmark Learning Early About Peanut study, which Dr. Lack spearheaded, investigated whether consuming peanut early and often helped prevent children from developing a peanut allergy.
In the LEAP study , babies were divided into two groups. One group started to consume peanut three times per week starting at 4-11 months of age, and continued this regular peanut consumption until they reached 5 years of age. The other group avoided peanut completely until they reached 5 years of age.
The LEAP study found that introducing peanut to babies early and often reduced their peanut allergy risk by more than 80%.
- Early: Starting between 4 and 11 months of agethe earlier the better
- Often: 2-7 times a week for at least 6 months
In the LEAP study, only 3% of the children who ate peanut regularly developed a peanut allergy by age 5. But 17% of the children who avoided peanut developed a peanut allergy by the age of 5. Thats an 82.35% difference between the two groups.