General guidelines for peanut allergy

When your child has a food allergy, they must follow an allergy-free diet. This means your child can't have the food they're allergic to or any products that contain it. 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. A peanut allergy is the leading cause of food allergy-related deaths in the U.S.

Peanuts are very different from tree nuts, such as walnuts, almonds, and cashews. But some people with a peanut allergy also need to stay away from tree nuts. Talk with your child's healthcare provider to find out if your child should also avoid tree nuts.

How to read a label for a peanut-free diet

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. It's up to you to carefully read all food labels.

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

• Arachis hypogaea (peanut plant)

• Artificial nuts

• Beer nuts

• Cold-pressed, expressed, extruded, or expelled peanut oil

• Goobers (another name for peanut)

• Ground nuts

• Mixed nuts

• Monkey nuts

• Nut pieces

• Nutmeat

• Peanuts

• Peanut butter

• Peanut flour

• Peanut protein hydrolysate

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

• Foods that aren't regulated by the FDA

• Cosmetics and personal care items

• Prescription and over-the-counter medicines and supplements

• Toys, craft materials, and pet foods

Foods that may contain peanut protein

The list below doesn't include all foods or products that may contain peanuts, but can help guide your decisions:

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

• Baked goods

• Candy, including chocolate and candy bars

• Cereals

• Chili and spaghetti sauce

• Crackers

• Egg rolls

• Enchilada sauce

• Flavoring (natural and artificial)

• Hydrolyzed plant protein

• Hydrolyzed vegetable protein

• Ice cream and frozen yogurts

• Marzipan

• Mole sauce

• Nougat

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 warnings aren't regulated by the FDA. Ask your child's provider if your child may eat products with these warnings on their labels. Or if your child should stay away from them.

What to know about possible sources of peanuts or peanut products

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

• Peanut butter, peanut flour, or both are sometimes used to make homemade chili and spaghetti sauce thicker.

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

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

When eating out with your child

• You or your child should carry 2 epinephrine auto-injectors. Make sure that your child and those close to your child know how to use it. If your child doesn't have epinephrine auto-injectors, talk with your child's provider.

• 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.

• Your child should wear a medical alert bracelet or necklace with their allergy information.

• Ask the server about ingredients and tell them that your child has a peanut allergy. Do this even if your child has eaten the foods there in the past. In a restaurant, food may be cross-contaminated with peanuts.

• Always read the labels on any packaged foods served to your child

• Don't let your child eat foods from a buffet that may contain peanuts. Any shared serving utensils could cause cross-contamination among foods.

Treatment

A medicine is now available to reduce the risk of allergic reactions in children with a peanut allergy. 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, you should still make sure they don’t eat peanuts or peanut products.