Peanut Allergy 101: Part Two

There is so much to know about peanut allergy! We explained how to understand it and how to make sure you get the correct diagnosis in the first part of this two-part series. Click here to catch up.

Managing the Allergy in Real Life

The traditional approach for a confirmed peanut allergy is complete avoidance of peanut products and carrying emergency epinephrine. Epinephrine is the definitive treatment for anaphylaxis – not oral steroids, not over-the-counter allergy medicine, not waiting to see if symptoms resolve.

Fortunately, treatment options for a peanut allergy are evolving. For some children, allergists may recommend oral immunotherapy, a treatment that involves gradually introducing very small, controlled amounts of peanut protein under close medical supervision. The goal isn’t necessarily to “cure” the allergy or make peanuts safe to eat freely, but to reduce the risk of severe reactions from accidental exposure.

Other approaches, including skin patches and additional therapies currently being studied, may also be options depending on a child’s age, allergy severity, and family preferences. These treatments aren’t right for every child, and they require careful discussion with an allergist to weigh benefits, risks and daily commitments. What’s most important is knowing that families now have more choices than ever and a personalized plan can be built to fit your child and your family.

Every child’s threshold or ability to tolerate peanut protein will vary. Peanut allergy testing doesn’t tell us how much peanut exposure it will take to set off an allergic reaction. For some children, even trace amounts or cross-contact with peanuts can cause severe reactions. Make sure you have a detailed conversation with your allergist to understand your child’s previous reactions. 

As you start reading ingredients and labels on packages, any food product that has the label “Contains: peanuts”, does in fact contain peanuts and should be avoided. Labels on packaged products should be read every time, even if ingested before, since manufacturers can change ingredients without warning. If you’re going out to eat or to get ice cream, communicate with the food handlers about the peanut allergy before you order your food. Peanuts can also be in foods that aren’t obvious at first, like sauces, baked goods, granola bars, and certain ethnic foods. When ingredients aren’t clear, reach out to manufacturers. It may feel overwhelming at first, but it gets easier, and it becomes second nature sooner than you think.

Be Prepared

When a peanut allergy is diagnosed, your allergist should review an emergency action plan that outlines symptoms to be aware of after an accidental ingestion and will walk you through what medications may be needed to help manage the reaction. Make sure you understand this emergency action plan at the time of diagnosis and ask questions if you have them. There are no silly questions when it comes to keeping your child safe. Take time to talk through your concerns with your child’s allergist and clarify anything that feels uncertain.

If your child has been prescribed an epinephrine device, it’s very important to keep the kit (which contains two doses) wherever your child goes, not just at home. Depending on the device, whether it’s an autoinjector, intranasal or sublingual, make sure you understand how it works and practice with a trainer if possible so that you feel confident before you ever need it. When it matters most, you’ll want to act quickly and calmly.

Having to become more vigilant doesn’t have to mean less life. With a safety plan and a bit more planning, the right knowledge and a community around you, your child can still enjoy snacks, parties and school.

There will be many moments to celebrate – safely navigating a field trip, teaching your child to speak up for themselves, or asking a restaurant about ingredients with confidence. With knowledge, preparation, and support, this diagnosis becomes something you manage, not something that manages you.