Managing Peanut Allergy
The only current treatment for this allergy is to avoid all traces of peanuts and peanut butter or other peanut-containing products. If your allergic child (or you) eats peanut with a known allergy, the drug epinephrine (adrenaline) will be needed to halt the reaction. But using the epinephrine auto-injector is an emergency situation only, it’s not a treatment.
This is why “avoidance” is the operative word for managing a peanut allergy. However, this isn’t as simple or easy as that one word suggests.
Now it may be obvious not to eat a peanut butter cookie, but many sources of peanut are not obvious. For example, peanut may be used in making egg rolls. You must also be aware of cross-contamination in kitchens – which occurs from using shared pans (the wok used for those egg rolls) or a peanut-butter-coated knife that’s thrust into a jam jar, leaving residue. There can also be issues of traces of peanuts in packaged or baked goods.
For a parent or person dealing with a newly diagnosed peanut allergy, getting used to looking out for peanut can feel overwhelming. But once you get the hang of some basics, you’ll find that peanut allergy is quite manageable. It just requires knowledge, sticking to certain rules and a new level of vigilance around food.
Hand-Washing: When your child (or you) has a peanut allergy, soap and water are your best friends. Hands should be washed thoroughly before and after eating. If you have a school-aged child, ensure he (or she) is able to wash his hands before snacks and lunch. With younger children, schools usually adopt an allergy protocol of washing hands among all children after eating. Even if your school allows peanut in common areas, washing up will considerably lessen the risk of exposure. Bring wipes with you at all times: they’re great for cleaning hands in a pinch, as well as wiping downs trays, tables and chairs when eating outside of your home.
Cross-Contamination: It’s important to make sure peanuts or peanut products don’t come in contact with the food you are eating. That means thoroughly cleaning utensils and kitchen equipment after use. For example, if someone makes a peanut butter sandwich on the cutting board, be sure to clean the board thoroughly with soap and water before using it to make your own, safe sandwich.
When there is a child or adult with a peanut allergy in the household, many families choose to eliminate all peanut from the house. This is a personal preference and will depend in part on your family’s ability to be vigilant about keeping the peanut-allergic person safe. (For instance, with a few young siblings, it may be more difficult to control peanut butter smears.)
Some people allow peanut butter but not bagged peanuts (peanut dust) while others keep a separate cutting board for the person with peanut allergies and ensure that all common cutlery is put through the dishwasher.
Label reading: Whenever you eat a packaged food, you need to read the label in its entirety to check for any mention of peanut. Sometimes, peanuts can have different names or can be hidden as an ingredient within a manufacturered food. You also have to look for precautionary statements on package labels, such as “May Contain Peanuts.”
The better news is that food labeling in both Canada and the United States has improved considerably in the past few years, especially for the Top Ten food triggers.
One thing to be cautious of with peanut allergy: imported foods. Not all countries have the stringent labeling requirements of Canada, the United States and the European Union. Don’t take chances if you suspect peanut could be an ingredient of an import.
Uncertain Foods: Managing successfully means not succumbing to temptation. And this is one of the harder parts of living with a peanut allergy because it has to be done 24/7, 365 days a year. If your hostess is “pretty sure” her delicious dessert from the fabulous bakery is peanut-free, just politely decline. Remember, we don’t “plan” accidents. The consequences of finding out the hostess was wrong are just not worth it!
Speak Up About Food: With food allergies, you have to ask questions and get over shyness when someone else – from Grandma, to auntie, to a waiter, to a teacher or a colleague – wants to serve food to you or your child with this allergy.
We teach kids to respect adults and authority, but with an allergic child, it’s important to teach them not to eat foods that others offer – unless mom or dad has pre-approved or (when they’re older) unless their sure of the ingredients. For adults, get over embarrassment, be certain to ask about ingredients, and learn to do this is an efficient, confident manner.
At School: For a parent of a child with peanut allergies, sending them off to school can be a time of anxiousness.
It’s important to communicate clearly and calmly with your child’s teacher and the principal, and to create an anaphylaxis emergency plan (also called a food allergy action plan) to protect your child. Also ensure that the teacher (and other staff e.g. a coach) is receiving at least annual training on using an epinephrine auto-injector and that he or she knows where your child’s “pen” is kept.
Become familiar with the anaphylaxis policy or law in your province or state and use it to develop a plan tailored to your child.
Be sure your allergic child knows not to share food with peers and not to take food from anyone, including the teacher, unless you’ve said it’s OK.
At a restaurant: Dining out with a peanut allergy may seem daunting at first, but it is possible to do so safely and enjoyably. First, find a restaurant you trust. Call ahead to ask the manager or chef about menu items and how they handle pans and utensils in the kitchen to avoid cross-contamination in the kitchen. If he or she is unable to answer your questions, don’t eat there.
When you arrive at the restaurant, tell your server directly of your serious peanut allergy and discuss menu items that will be safe to eat. If you don’t feel he or she is able to answer your questions properly, ask to speak to the chef or the manager. Be mindful of particularly risky foods: sauces, desserts, salad dressing and items that may be cooked in peanut oil. Some restaurants will become off-limits: for example, an Asian restaurant that’s known for using peanuts and peanut oil in their dishes. And remember: when in doubt, don’t eat it.
Be prepared: Make it a rule – no epinephrine auto-injector means no food. While you’ll do everything to make sure you’re not eating peanuts, accidents happen. Make sure you always have your auto-injector on you when you eat, in case of an emergency. If your child is allergic, make sure this rule is one he or she takes seriously.
Educating Others: In order to successfully manage a peanut allergy, those around you/your child need to be aware of the allergy and the serious consequences that could result from eating peanuts.
Plan what you’ll say to others to explain this condition. Be calm, clear about the information and keep the conversation based on facts. Politely request that they help you keep yourself or your child safe. You’ll often find that once a person understands about food allergies and anaphylaxis, they’ll be more than willing to help out. Be mindful that there is a learning curve, and don’t expect people who don’t live with peanut allergy to absorb it all as quickly as you have.
A final note: Peanuts allergies are one of the most common allergies, especially in kids, and are widely recognized. This can be beneficial, as many people are aware of their severity and many products exist that are “peanut-free”, often with logos on them designating them as such. With vigilance and support from those around you, you or your allergic child can lead a full and safe life with peanut allergy.