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Navigating a nut allergy is easier than you think. But it does mean doing your homework.

Think about the items in your house that contain nuts. You might have cashew butter in the pantry. Maybe it’s a bag of mixed nuts in a desk drawer. Or a hidden container of Rocky Road ice cream in the freezer. Regular products you probably use regularly without worry. But for someone with a nut allergy, they can spell trouble. Here’s what to know.

What are nut allergies?

Nut allergies are the most common type of serious food allergy. Reactions happen because of contact with tree nuts, including:

  • Almonds
  • Brazil nuts
  • Cashews
  • Hazelnuts
  • Pecans
  • Pistachios
  • Walnuts

“After someone with a nut allergy has an exposure, the immune system overreacts to proteins in the nuts, which triggers an allergic reaction,” says Dr. David Anmuth, pediatric allergist and immunologist at Geisinger. 

Exposure to tree nuts can happen in a few ways:

Direct contact with nuts or nut products. Eating (or sometimes touching) products that contain nuts.

Cross-contamination. When food accidentally comes into contact with nuts.

Besides tree nuts, you can be allergic to peanuts. “Having a peanut allergy doesn’t automatically mean you’re allergic to tree nuts,” says Dr. Anmuth.

What are the symptoms of an allergic reaction? 

Allergic reactions look different for everyone. Symptoms of nut allergies can range from mild to life-threatening. They include:

  • Nausea or vomiting
  • Diarrhea
  • Itchy skin
  • Hives
  • Tingling of the mouth and throat
  • Swelling of the lips or mouth
  • Coughing
  • Hoarseness

“The most severe allergic response is anaphylaxis, which comes on fast and is life-threatening,” says Dr. Anmuth.

Call 911 or head to the nearest emergency room if your child has any of these severe symptoms:

  • Trouble breathing
  • Swelling in the throat
  • A sudden drop in blood pressure
  • Pale skin or blue lips
  • Dizziness
  • Fainting

Navigating nut allergies: How to protect everyone

Staying informed is key to handling any allergy. With some preparation and prevention, your child can feel their best. Follow these steps to reduce the likelihood of an allergy emergency:

Make a plan with their doctor. If your child has a nut or peanut allergy, their doctor will draft an emergency care plan. This care plan offers instructions on how to treat allergic reactions. It may include information on:

  • Your child’s dietary restrictions
  • Symptoms 
  • Situations that might require an EpiPen
  • When to call 911

Keep everyone in the loop. Discuss your child’s food allergy emergency plan with anyone who spends time with them, like teachers, coaches and daycare providers. “Keeping communication open can reduce your child’s risk,” notes Dr. Anmuth.

Read labels. Products that don’t contain nuts may still pose a risk of contamination. Even if it’s something you buy regularly, check the container. This can help you identify any changes to labeling or ingredients. After you’ve checked the label, look for these phrases on the package:

  • “May contain traces of tree nuts.”
  • “Processed in a facility that also processes nuts.”

If you see similar phrasing, the product may be risky. To be sure the product is nut-free, choose labels that say “made in a dedicated nut-free facility” or something similar.

Practice kitchen safety. Avoiding accidental nut exposure starts with your kitchen. “If you keep nuts in your home, be mindful of cross-contamination from cutting boards, utensils and cookware,” says Dr. Anmuth.

To keep mealtime as safe as possible:

  • Create a dedicated nut-free cooking area
  • Wipe down surfaces before and after cooking
  • Store foods with nut ingredients in separate containers. And, if possible, in a separate fridge or cabinet.

Rely on meal prep. Consider packing your child’s lunches for school for an added layer of protection. And for birthday parties or get togethers, think about making snacks yourself. If your child is attending an event, send them with nut-free provisions to keep them full.

Ask ahead of time. If you plan to eat at a restaurant, choose carefully. Start by browsing menus online. Or, for extra security, contact the restaurant directly. Ask if their menu is safe for someone with a nut allergy. If it isn’t, look for another spot.

When in doubt, communicate

Helping your child manage a nut allergy takes work. But by arming yourself with information you’ll help everyone. Have a conversation with your child(ren) about nut allergies. Let them know which things are “safe foods” and which are “unsafe foods”. Besides talking to your kids, chat with your friends and neighbors, too. Whether they’re aware of the allergy or not, a conversation can keep everyone on the same page.

 

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Meet David Anmuth, MD