General guidelines for peanut allergy

When your child has a food allergy, he or she must follow an allergy-free diet. This means your child can't have the food they are allergic to, or any products containing that food. The items that your child is allergic to are called allergens.

A peanut allergy is the body's abnormal response to the proteins found in peanuts. Peanut allergy is the leading cause of food allergy-related deaths in the U.S.

In order to not eat foods or use products that contain peanuts, it's important to read product labels. Peanuts are very different from tree nuts. But some people with peanut allergies also need to stay away from tree nuts. Tree nuts include walnuts, almonds, and cashews.

The Food Allergen Labeling and Consumer Protection Act (FALCPA) requires U.S. packaged foods to state clearly on the label if they contain peanuts. Federal law requires that all foods regulated by the FDA must list peanuts as an ingredient if they contain peanuts. The lists below may not include all foods or products to stay away from. But they can help guide your decisions. It is up to you to carefully read all food labels.

Treatment

A medicine is now available to treat peanut allergy in children. The FDA-approved medicine is for children and teens ages 4 to 17. A child with a confirmed peanut allergy can start taking the medicine at age 4. Talk with your child’s healthcare provider to find out if this medicine can help your child. If your child is taking this medicine, continue to make sure they don’t eat any peanuts or peanut products.

How to read a label for a peanut-free diet

Don't give your child foods that contain any of the following ingredients:

• Arachis hypogaea. This is the scientific name for the peanut plant.

• Artificial nuts

• Beer nuts

• Cold-pressed, expressed, or expelled peanut oil

• Goobers

• Ground nuts

• Mixed nuts

• Monkey nuts

• Artificial nuts

• Nut pieces

• Nutmeat

• Peanuts

• Peanut butter

• Peanut flour

• Peanut protein hydrolysate

Foods that may contain peanut protein

• African, Chinese, Indonesian, Vietnamese, Thai, and other ethnic dishes

• Baked goods

• Candy

• Cereals

• Chili and spaghetti sauce

• Chocolate in candy or candy bars

• Crackers

• Egg rolls

• Enchilada sauce

• Flavoring (natural and artificial)

• Hydrolyzed plant protein

• Hydrolyzed vegetable protein

• Ice cream and frozen yogurts

• Marzipan

• Mexican dishes

• Mole sauce

• Nougat

What to know about other possible sources of peanuts or peanut products

• Most children with allergies can safely eat foods with peanut oil, unless it is cold-pressed, expressed, or expelled peanut oil. Don't give your child cold-pressed, expressed, or expelled peanut oil. Ask your child's healthcare provider if it's safe to give your child foods with or cooked in other types of peanut oil.

• Some products have warning labels such as "may contain peanut" or "made in a facility that may have processed peanuts." Ask your child's healthcare provider if your child should stay away from products with these statements.

• Peanuts are very allergenic. They could cause a fatal reaction if eaten by a child who is allergic to them.

• Ethnic foods, commercially made baked goods, and candy can be cross-contaminated with peanuts. This is because peanuts are often used in these types of foods.

• Peanut butter, peanut flour, or both are sometimes used as thickeners in homemade chili and spaghetti sauce.

• Foods made with hydrolyzed plant and hydrolyzed vegetable protein may contain peanuts.

• Artificial nuts are peanuts that have been deflavored and reflavored with a nut such as pecan or walnut.

Foods that don't contain peanuts could be contaminated during manufacturing. It's important to know that some labels are voluntary. These include "processed in a facility that also processed peanuts" or "made on shared equipment." These are not regulated by the FDA. Ask your child's provider if your child may eat products with these labels. Or if your child should stay away from them.

There are some foods and products that are not covered by the FALCPA law. These include:

• Foods that are not regulated by the FDA

• Cosmetics and personal care items

• Prescription and over-the-counter medicines and supplements

• Toys, crafts, and pet foods

Your child should always carry 2 epinephrine auto-injectors. Check that your child and those close to your child know how to use it. Your child should wear a medical alert bracelet or necklace with their allergy information. If your child doesn't have epinephrine auto-injectors, talk with your child's healthcare provider. Ask if your child should carry them.

In a restaurant, food may be cross-contaminated with peanuts. Always read the labels on your child's food. And always ask about ingredients at restaurants. Do this even if these are foods that your child has eaten in the past. Your child should stay away from buffets with peanuts. This can help prevent cross-contamination of foods with shared utensils.