Health and lifestyle
Managing peanut allergy
Alexis Manning of Peanut Allergy UK looks at how parents can help their child to deal with this increasingly common allergy
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Peanut alergy is becoming more common: a recent study of school-age entry children found that 1.8% of children were affected, compared to only 0.5% a decade before. Reactions to peanuts can be variable, ranging from itching or hives to collapse or difficulty breathing (anaphylaxis). There is no guarantee that someone who had a trivial reaction will not suffer a severe life-threatening reaction on their next exposure to peanuts. Because these reactions can be triggered over seconds to minutes from a very small amount of peanut, extreme vigilance is required. However, they can usually be reversed with the administration of adrenaline, so most people with peanut allergy are prescribed autoinjectors of adrenaline (EpiPens) to carry with them.
There is currently no effective treatment for peanut allergy apart from strict avoidance, although there is promising research in the pipeline and some drugs for other conditions that may be of use against severe allergy in the future. Some studies indicate that about 20% of children may outgrow peanut allergy, but this is a very controversial area and generally it is accepted that peanut allergies that persist into adulthood will be lifelong. There are only six consultant-led allergy clinics in the UK , so it can be difficult for allergy sufferers to get information. In my personal experience, I was diagnosed 15 years ago after an anaphylactic reaction and was prescribed EpiPens. There was no further support available.
Because of this I set up the Peanut Allergy UK website (see www.peanutallergyuk.co.uk), which includes a forum to allow sufferers to share and discuss issues such as safe foods, nut-free manufacturers, restaurants, schooling, travelling, food recalls, current research, and information about other allergy resources. When newly diagnosed, it can seem like you can’t eat anything and it can be very valuable to get the perspective of other sufferers since the vigilance that is required to avoid peanuts can easily become paranoia, particularly when your children are involved. Multiple food sensitivities are common and can make a restricted diet even more difficult.
A peanut allergy can turn something as common as arranging a birthday party for your child into a minefield, and the forum allows people to benefit from the experience of others. It is important to bear in mind that no such forum can substitute for medical advice, however, and better provision for allergy services on the NHS is ultimately what is required.
However, the outlook is not all bleak. The situation with food labelling has massively improved in recent years, thanks to EU labelling regulations that require any peanuts to be declared. Manufacturers have become more sparing with “may contain nuts” warnings, and eating a balanced diet has become much simpler. Schooling can potentially be an issue because children will bring in food from home and may share it; some lessons may involve cooking or potential exposure to peanuts; and there may be issues as to which staff members are trained to use EpiPens and where they will be kept in school.
As awareness of the allergy has increased, however, it is more common for schools to have plans in place for such children and to be supportive. They should be made aware of your child’s allergy as soon as possible. I would suggest to anyone with a newly-diagnosed family member to clear all peanuts and nut-containing foods out of the house to make it a safe haven for food. Even for people who are just allergic to peanuts, avoidance of all nuts is often more straightforward given the potential for cross-contamination if different nuts are processed in the same factory.
Although labelling has improved, there are many synonyms for peanut in ingredient lists that it’s important to be aware of, such as “ground nuts”, “monkey nuts”, “arachis”, or “mixed nuts”. Peanut oil is theoretically safe if refined, but again it is less stressful to avoid it entirely. The ingredients list of cosmetics should also be carefully inspected, since these sometimes use peanut oil as a base. While this may seem extremely daunting, the experience of people on the forum is that many supermarkets are excellent with their labelling, with particular praise for Sainsbury’s, Waitrose and Marks and Spencer.
Supermarket in-house bakeries usually have a sign warning of the possibility of cross-contamination with nuts. Desserts and sweets are often particularly at risk of cross-contamination and their ingredient list should be examined carefully. Foods that state “may contain nuts” should be strictly avoided.
The potential contamination with nuts may vary from batch to batch, so such a food could be eaten without problems on many occasions before it causes a reaction. These warnings are less liberally used now than they have been in the past. Often there are minor symptoms after eating food with nuts, such as a tingling or swelling of the lips or a bad taste in the mouth. These should not be relied upon and food should never be “tested” by taking a small amount, since a severe reaction could occur.
 Reactions to peanuts can be triggered over seconds to minutes from a very small amount of peanut, so extreme vigilance is required |
If a reaction occurs it is best to be safe, use the EpiPen and go to hospital as soon as possible. Parents should be aware that one EpiPen may not be enough to control the reaction and that the effects can wear off. Again, it is best to go to hospital in the event of any reaction: some adult sufferers are willing to “wait out” minor reactions by taking antihistamines, but it should be noted that while these may mask minor symptoms, they cannot be relied upon to prevent a reaction progressing.
All these precautions can be very stressful for children, and it is important to make sure they have a healthy relationship with food. However, it often seems that the problem is more stressful for the parents! Children seem to be very good at understanding that they must always ask an adult before eating any food.
In summary, while dealing with peanut allergy may seem very difficult initially, better food labelling has made it easier now than ever before. People are much more aware of the allergy and many manufacturers will provide nut-free lists on request. While it is necessary to be very careful with food, it is important to keep it in perspective and make sure it doesn’t become something that rules your life – or your child’s.
For more information, visit: www.peanutallergyuk.co.uk
