Families

In January 2017, the National Institutes of Health published an addendum to the guidelines for the prevention of peanut allergy in the U.S. These guidelines recommend the early introduction of peanut protein in infants starting at between 4-6 months of age depending on risk (low, medium or high) to prevent peanut allergy. They also provide ways to simply introduce peanut protein to babies (through thinned peanut butter, peanut puffs or powdered peanut butter) and recommendations for how frequently infants who are at-risk for peanut allergy should eat peanut foods (at least 3 times per week). If a baby isn’t at risk for peanut allergy, parents can offer peanut foods as often as they would like. As always, parents should discuss specific dietary needs for their child with a healthcare professional.

Education from a medical professional and having a food allergy management plan are key. The more you, your child and those around you know about the allergy, the more you can all do to protect the child. Food Allergy & Anaphylaxis Connection Team (FAACT) has valuable resources to help. Also, be sure to check out AllergyEats, a guide to allergy-friendly restaurants across the country.

Research supports that people with peanut allergies are highly unlikely to have serious reactions as the result of casual contact and that simple soap and water cleans surfaces and hands of peanut proteins. The researchers in this study were also unable to detect the airborne allergen.

Another research study looked at how people with peanut allergies would react to peanuts and peanut butter in their environment. Thirty peanut-allergic children who had previously reported having severe reactions to smelling or touching peanut butter were exposed to the smell of peanut butter for 10 minutes and there were zero reactions. In the same study, peanut butter was placed on the child’s skin and there were no life-threatening reactions; some experienced redness or irritation where the peanut butter touched the skin.

Ingestion has the potential to cause reactions, some of which could be severe. It is important for people with peanut allergies to use caution to prevent accidental ingestion. Since reactions are unpredictable, every allergic individual should maintain a food allergy action plan to help keep them safe.

You should always consult an allergist if you have concern about a food allergy. Working with an allergist who is familiar with your health history would assist in managing a food allergy risk.

Research:

• Simonte, et al. Relevance of casual contact with peanut butter in children with peanut allergy
• Perry, et al. Distribution of Peanuts in the Environment
• Wainstein, et al. Frequency and significance of immediate contact reactions to peanut in peanut-sensitive children
• 2017 Addendum Guidelines for the Prevention of Peanut Allergy in the United States (NIAID): Guidelines for Clinicians and Patients for Diagnosis and Management of Food Allergy in the United States

Published expert opinions:

• Allergic Living – Advice on reacting to smell of peanut
• FAAN Newsletter – Common Beliefs About Peanut Allergy by Dr. Michael Young

More than 99% of Americans can enjoy peanuts without any issue, but according to the National Institute of Allergy and Infectious Diseases (NIAID), peanut allergies affect 0.6% of us.* Just as if it were your child with a peanut allergy, educating yourself and those around you is critical.

Reduce cross-contact with peanut-containing foods by having them clearly labeled if serving foods in a public setting. Be sure to wash hands, utensils, and other objects that may have come into contact with peanuts with soap and water to reduce the risk of transferring peanut allergens. Communication is also key – when possible, inquire about whether another person has a food allergy and be aware of anything they may need to manage an allergic reaction.

The more you know, the more you can do to ensure peanuts and peanut butter can be consumed safely without endangering someone with an allergy.

* https://www.niaid.nih.gov/sites/default/files/addendum-peanut-allergy-prevention-guidelines.pdf

Abrams EM, Chan ES, Sicherer S. Peanut Allergy: New Advances and Ongoing Controversies. Pediatrics. 2020;145(5):e20192102. doi:10.1542/peds.2019-2102

A 2022 study published in the World Allergy Organization Journal suggested that consumption of peanuts during pregnancy may significantly decrease the likelihood of a peanut allergy in children. The participants in the study were 903 children in Taiwan between the ages of 1-3 years. The Southern Taiwan Allergy Research Alliance (STARA) Food Allergy questionnaire collected data on prenatal and perinatal food allergy risk factors and self-reported allergic symptoms. Researchers found that maternal peanut consumption during pregnancy was associated with a decreased risk of a peanut allergy in children.

These results are similar to an earlier 2013 study where researchers examined the association between the consumption of peanuts and tree nuts during pregnancy and the risk of peanut and/or tree nut allergy in children. The study included 10,907 children born between 1990-1994 born to women who had reported their diet during, before, or after their pregnancy, with a follow-up in 2006 to determine any physician-diagnosed food allergies. Researchers found that children whose mothers ate peanuts during pregnancy and breastfeeding had a lower risk of developing a peanut allergy.

Furthermore, a consensus statement published in 2021 by the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical Immunology stated that there is no evidence that maternal exclusion of common allergens including peanuts during pregnancy or lactation is effective in preventing food allergies.

The United States Food and Drug Administration (FDA) exempts highly refined peanut oil – typically used for frying – from being labeled as a peanut allergen because the allergenic protein has been removed during the refining process. However, cold-pressed, expelled or extruded peanut oil is still allergenic – usually found as aromatic or gourmet oils. Those with a peanut allergy should always ask for clarification if they are unsure about which oil is being used.