Tree nuts include all nuts that grow on trees (such as walnuts and cashews). A tree nut allergy is a reaction by your child's immune system to tree nuts. Our immune systems normally respond to invaders that attack the body such as bacteria or viruses. A food allergy occurs when the body's immune system mistakenly believes that a harmless food substance (such as tree nut proteins) is harmful. In order to protect the body, the immune system creates substances called antibodies to that food. The next time you eat that particular food, your immune system releases huge amounts of chemicals, such as histamines, to protect the body. This is what causes the symptoms.
Tree nuts are among the 8 foods responsible for most food allergies in children. The other foods include milk, soy, eggs, peanuts, wheat, fish, and shellfish. Many children grow out of food allergies to egg, milk, or soy. It is less likely that children will grow out of peanut or tree nut allergies.
Most healthcare providers warn not to feed your child shellfish and food containing peanuts and tree nuts, until age 2. If you have a family history of allergies, some recommend waiting until 3 years.
If you suspect your child is having an allergic reaction to nuts or any other food, it is important to get a diagnosis from your healthcare provider or allergist. Symptoms can include:
With a tree nut or peanut allergy, it is more common to have an anaphylactic reaction. This is a serious reaction that is sudden, severe, and can involve the whole body. It can cause swelling of the mouth and throat, dangerously low blood pressure, and trouble breathing. This type of reaction is a medical emergency. It is treated with epinephrine (a medicine that is given by injection). Usually parents or caregivers of children who have severe allergic reactions carry their own shot kits, just in case of emergency.
An allergic reaction to a food usually starts within minutes but may be delayed 2 to 4 hours. It usually lasts less than 1 day. The more severe the allergy, the smaller the amount of food it takes to cause a reaction.
Peanuts grow underground and are not considered to be a "true nut." Peanuts are in the legume family (peas and lentils are also legumes). Nuts such as walnuts, almonds, pecans and cashews grow on trees. About half of the people with a peanut allergy are also allergic to tree nuts. You'll need to check with your healthcare provider whether it is safe for your child to eat peanuts.
The only way to not have a reaction is to avoid the food that causes the allergy symptoms. Your child will need to avoid all sources of tree nuts. You will need to change the way you shop for, prepare, and order food. Be sure to check the ingredients on food package labels and ask the waiter about how foods are prepared when dining away from home.
If you are breast-feeding, eliminate the food your child is allergic to from your diet. Food allergens can be absorbed from your diet and enter into your breast milk.
The first step is to read labels and get familiar with ingredients that contain tree nuts. Reading labels and having an awareness of ethnic and convenience foods that may not have labels is key. Always ask about ingredients if you are not sure. When in doubt, don't use the product.
Nuts and foods that contain nuts
Nutmeg is safe (made from the seed of a tropical plant) and coconut is usually safe, but it is wise to consult your healthcare provider first. Note that non-food items such as Hacky Sacks (kick sacks) and beanbags are sometimes filled with crushed nutshells. Inquire about the filling before purchasing.
Foods that often contain nuts
Hidden sources of nuts
Cross contamination is a problem when trying to avoid nuts. Other foods often come in contact with nuts during processing and in preparation. This is true even if nuts are not part of the recipe.
The following foods are sometimes contaminated with nuts:
When dining out:
Reading labels to avoid allergens has become a lot easier. Foods that contain milk, eggs, fish, shellfish, peanuts, tree nuts, wheat, or soy products must list the food in plain language on the ingredient list. For example, marzipan (almond). The specific tree nut (almond, cashew, walnut) must be clearly stated. These possible allergens must be listed even if they are part of a flavoring, coloring, or spice blend. There are still some things to watch out for when reading food labels:
It is very important for you to know less common names and scientific names for food ingredients.
Your child can still have a nutritionally complete diet. The primary nutrients found in nuts are protein, healthy fats, fiber, vitamin E, and magnesium. There are many other foods that contain the same nutrients as tree nuts. The challenge is not providing adequate nutrition, but to keep your child from unknowingly eating foods that contain them.
You can make desserts from scratch or mixes that do not contain nuts. Some companies make products without nuts. They also have processes to avoid the risk of cross-contamination with nuts. This would be stated clearly on the label.