AAIQ   The Association of Allergists and Immunologists of Québec

Peanut Allergy

The peanut is one of the most common food allergens. About 1% of the population has a peanut allergy.

Is the peanut a nut?

The peanut is part of the legume family and not part of the nut family. Although many people allergic to peanuts are not allergic to nuts, a certain number of people are allergic to both. Even though the peanut is part of the legume family, the majority of people with a peanut allergy tolerate other legumes (lentils, peas, beans, etc.).

How does one avoid peanuts?

As for most other food allergies, treatment always begins with avoidance. In addition to informing those around you and taking precautions to avoid contamination, you must attentively read all food labels, since the peanut protein can be found in many different foods. Other names may be used to designate peanut: arachides, cacahuètes, Goober nuts, mani, mandelona, valencia, etc. (see the site of the Canadian Food Inspection Agency for a more exhaustive list). At all times, in Canada, a law mandates that companies must clearly indicate the word "peanut" in the list of ingredients, and must not use other terms.

What is the evolution of a peanut allergy?

In the majority of cases, allergy to peanuts is persistent and lifelong. Typically studies have shown that about 20% of children may lose their allergy to peanuts over time.

Prevention of peanut allergy

New guidelines released by the US National Institute of Allergy and Infectious Diseases (January 2017) now recommend that to reduce the risk of peanut allergy, infants should eat foods containing peanuts by the time they are six months old.

Studies have shown that instead of delaying introduction of peanuts as had previously been recommended, active early introduction of foods may reduce allergy and improve tolerance.

The guidelines suggest that infants at high risk for peanut allergy (those who have severe eczema, egg allergy, or both) be exposed to peanuts in their diet between 4-6 months of age, after discussions with their health care provider. Occasionally, allergy testing may be performed to guide this approach. For infants with mild to moderate eczema, it is recommended that peanuts be introduced into their diet around 6 months of age. For infants without eczema or other food allergies, it is recommended that peanuts be freely introduced into their diets.

Infants should start other solid foods before eating peanut containing foods, and peanuts should never be given in nut form, or as spoonful’s of peanut butter to reduce the risk of choking. Once peanuts are tolerated, infants should continue to eat foods containing peanuts several times a week to promote tolerance.

The addendum guidelines have been published in the Canadian journal Allergy, Asthma and Clinical Immunology. It is important to discuss these recommendations as they concern your child with your doctor, in order to come up with the most appropriate strategy.

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Nha Uyen Nguyen-Luu, MD FRCPC
Andrew Moore, MD FRCPC