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Illness prevention and treatment

August 14, 2012

How to handle your child’s peanut allergy

With new food products and increased awareness, parents have more tools than ever to prevent and treat an allergic child’s encounter with peanuts.

peanut allergy

Janie Park’s son William was a year old when his life with a peanut allergy officially began. The family had just enjoyed a falafel lunch at a Middle Eastern restaurant when William, who’s now three, began developing red splotches around his mouth. Minutes later he seemed asleep in his stroller. It was only after Park transferred him to his crib that warning bells went off.

“He was crying weirdly, so I went in to his room,” she remembers. “He had hives everywhere and his mouth was swollen, his face was swollen. I was totally freaked out.”

When Park rushed her son to the local hospital, she was expedited through the emergency ward. “The receptionist looked at him and said: ‘Go right now,’” Park says.

Later, after giving William a dose of oral antihistamine to combat the allergic reaction, a doctor told Park he suspected her son had eaten a trace amount of peanuts. He prescribed an EpiPen, a one-shot, life-saving dose of epinephrine, a hormone that can open a closed airway during the severe allergic reaction called anaphylaxis.

Now, two years later, Park is ever-vigilant. She has warned William’s preschool of his allergy and shown all the caregivers there how to use an EpiPen. The preschool has been made a peanut-free zone. And before every play date, Park reminds other parents of her son’s allergy.

Now that William has turned three, an appointment with the allergist is scheduled to determine how severe his allergy is. “I’m hoping to hear he’ll just grow out of it,” Park says.

Peanut allergy is common

In Canada, up to 1.5% of children are allergic to peanuts, according to the Allergy/Asthma Information Association.

That means as many as 15 kids out of every 1,000 have to stay away from peanuts or they’ll experience symptoms ranging from hives, facial swelling, nausea, vomiting and diarrhea, to a sharp drop in blood pressure (turning white or fainting), swelling of the airways causing trouble breathing, an inability to speak and unconsciousness. If the airway shuts completely, they could die within an hour, or even within a few seconds, says Monika Gibson, regional coordinator for Ontario of the Allergy/Asthma Information Association.

“The most important thing we stress is give the EpiPen as soon as possible,” she says. “The EpiPen freezes the reaction at the point it’s at. If you wait until [the child] is unconscious, you may not get them back.”

And don’t worry about administering epinephrine unnecessarily. “If it turns out the individual was not suffering an anaphylactic reaction, you may have a more hyper person,” says Gibson. No harm done.

Preventing peanut exposure

For now, there is no cure for peanut allergy. “There is a lot of very interesting research at the clinical level,” says Stuart Carr, president of the Canadian Society of Allergy and Clinical Immunology. “We may have some treatment options imminently.” These include oral food desensitization, a form of immunotherapy in which an individual is given gradually larger amounts of an allergen until no allergic response is shown, and which must always be conducted by a health care professional in a controlled environment.

But, he acknowledges, “there aren’t really many treatment options now for patients walking into the clinic today.” For that reason, prevention is your best line of defence:

  1. Choose products labeled peanut-free.
  2. Know your ingredients – peanuts can be listed under a variety of names. Forgo products that “may contain peanuts” and skip items with peanuts by another name: peanut oil, beer nuts, ground nuts, mandelonas, goober nuts, valencias, etc.
  3. When dining in restaurants, ask your server about the ingredients in a given dish. Gibson recalls an individual who had a reaction to lasagna that had been thickened with peanut butter.
  4. Bring food you have prepared at home to your child’s school, play date and party.
  5. Don’t give a caregiver or teacher a list of items that are safe for your child to eat, advises Gibson. That’s because while individually wrapped products may be peanut-free, they may be contaminated when bought in bulk. For example, chocolate buds may be safe in their packaging, but may come in contact with peanuts if in an open bin in a health food or bulk food store.
  6. Teach caregivers and teachers how to use an EpiPen. On the first day of preschool, Park showed every caregiver how to use the device and had each sign a form acknowledging this training.
  7. Have your child carry an EpiPen at all times, and carry additional units when travelling. “Mom and dad should both have one,” recommends Gibson.

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