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Nut Allergies

Many moons ago, when Maya was a wee thing of only 18 months old, she had an allergic reaction to peanut butter, which landed us in the allergist’s office for allergy testing. The almost immediate hives that sprung up on her back in several spots made it apparent we were dealing with a nut allergic kiddo. Sure enough, after the testing window was up, the results indicated a fairly severe allergy to peanuts, cashews and pistachios. Epipen in hand we went on our way.

Here we are 3.5 years later and we found ourselves in the allergist’s office again. Our pediatrician in St. Louis recommended retesting Maya at 5. Our pediatrician here in Seattle said she would have probably recommended retesting sooner, but 5 worked, so she referred us to a great allergist here. I admit I was hopeful going into this appointment. Perhaps too hopeful.

Our appointment was first thing in the morning and this clinic deals with a lot of pediatric patients so they were well equipped for my two kiddos to be running through their halls. The staff was wonderful, the receptionist got us checked in super fast and the nurse has us back in the office 20 minutes before our scheduled appointment! The nurse was great and super friendly with Maya, which helped calm her nerves a little. After a brief once over by the nurse the doctor came in. She was super sweet and very informative. We went over Maya’s history at length, including everything I could remember from her previous appointment, many moons ago. She went over in great detail what they are looking for in retests, specifically what indicators they hope for that would show Maya is perhaps on her way to outgrowing this allergy and what indicators would show that she may be one of the 20% who never outgrow their food allergy.

Once our long, and very informative conversation with the doctor was over it was time for the actual testing. Maya is, shall we say, a bit over dramatic when it comes to needles, bandaids, pricks of any kind from medical professionals. I had done my best to prepare her for what to expect at this appointment but I don’t think she completely understood. She flipped out a bit when the nurse came in with a tray full of little pins! The nurse did a great job of calming her down and talking her through everything she was going to be doing. Maya laid down on the table and was super brave. She did cry the whole time, but given her history for melodrama I was very impressed. With the allergens in place on her back we began the waiting game.

The waiting game didn’t last long. Within minutes she started to develop hives in several locations including the peanut, cashew and pistachio spots. Halfway through the testing window the nurse came in to check on her and this is what her back already looked like :(

6 minutes later when the test was complete each hive was bigger and there was no question she was definitely still allergic. The nurse came in and measured each of the reaction sites. The doctor returned to go over the results. Just as I had expected from watching the hives rapidly develop on her back during the test she is still severely allergic to peanuts, cashews and pistachios, and has now added pecans and brazil nuts to the mix. Her allergy has not gotten any better over the last 3+ years, in fact it has gotten worse. Each of her reactions was worse than her previous testing plus she reacted to 2 new nuts. I was so incredibly bummed by that news.

So, what do the results mean? Well, they mean that Maya is still severely allergic to peanuts and tree nuts (more so than before). She will still require an epipen. And, she is getting closer to the likelihood that she will never outgrow this allergy. The doctor recommended retesting in 3-4 years to see where we are. There is still hope for her to outgrow this allergy, but her chances definitely took a big hit today.

The long standing warning from pediatricians and other health care professionals to avoid introducing nuts into your child’s diet until they are 3 years old has recently been changed.  Studies have found that it could be that waiting to introduce nuts into your child’s diet may actually increase their chances of developing a nut allergy.  Only about 1-2 percent of children are predisposed to nut allergies because of a family history.  By introducing nuts earlier children without a predisposition may be much less likely to develop the an allergy.

Recently the AAP (Amercian Academy of Pediatrics) changed it’s long standing policy regarding nuts and is now recommending introducing nuts into a child’s diet as early as 6 months of age if the child has shown no signs of other food allergies and there is no family history of nut allergies.  For many parents, especially those with older children who had to avoid nuts for so long it may be hard to accept the new recommendations.  Nut allergies are scary to many parents and taking that first step and giving your child something that contains nuts for the first time is very nerve-wracking.

When introducing nuts parents should be sure to give their child a very small amount the first time and be careful to watch for signs of an allergic reaction.  Common symptoms of an allergic reaction include: wheezing, stomachache, vomiting, diarrhea, hives and swelling.  If you suspect an allergic reaction contact your child’s doctor and if the symptoms are severe seek medical treatment immediately.

Be sure to talk to your child’s pediatrician about these new recommendations and make sure you have all the facts and information before beginning to introduce nuts into your child’s diet.

Remember it is not safe for children until the age of 5 to have whole nuts.  Any nuts your child consumes before the age of 5 should be in spread form, or ground into other foods.

Having a child with a nut allergy (or any food allergy for that matter) poses particular challenges when they start choosing foods for themselves.   When Maya was diagnosed with a peanut and tree nut allergy last year that was one of the first things I worried about.  I knew that for the time being I would be able to protect her, for the most part, by choosing her foods for her, being diligent about reading labels and directing others about what she could and could not eat.  But, what was I going to do when she started being places on her own, choosing her own foods, being exposed to foods that I didn’t pick out or read the labels of before hand?

For children with life threaten nut allergies the consequences can be devastating if they inadvertently eat something that contains nuts.  My daughter has an epi-pen that we can use if she happens to have an anaphylactic reaction, but still.  The best approach to helping avoid potentially dangerous exposure to nuts is to teach your child from a very young age what to ask and what foods to avoid so they can be their own advocate.

We’ve already started teaching Maya that she can’t eat nuts.  She is still to young to really get it, but slowly I see it sinking in.  Sometimes I say she can’t have something at the store and she’ll respond by saying “ya, nuts, no nuts.”  I guess after hearing it so many times she’s starting to get it.

A few of the things I’ve started doing already to help Maya learn about her nut allergy and what she needs to do are:

  • Telling her whenever I can why she can’t eat something.  If she can’t have a piece of chocolate or a cookie because it may contain nuts I tell her that.
  • Telling her that she can’t eat nuts and why.  I try to explain that nuts are dangerous for her and her body will have a bad reaction if she eats them.
  • Showing her what nuts look like and telling her she can’t eat them so that she will recognize them if someone offers one to her.

A few things we plan on doing as Maya gets a little older to help her learn what to ask and what to avoid:

  • Teach her to ask if something has nuts.
  • Continuing to teach her about the foods she must avoid and those she needs to be careful about.
  • Teach her to use her epi-pen when she is old enough.
  • Teach her to tell people who are offering her food that she is allergic to nuts so hopefully they will help her avoid dangerous foods.

I think that teaching your child to be their own advocate is very important.   You tell those caring for your children about the nut allergy, how to use the epi-pen, etc, but teaching your child about their allergy and making them an advocate for themselves creates another line of defense.

Do you have a child with a food allergy?  What things have you done with your child to help teach them about their food allergies?  Have you found some things work better than others?

halloween candy

Before Maya was diagnosed with a peanut and tree-nut allergy I didn’t give any thought to what kids with nut allergies did on Halloween.  Trick-or-treating is a big part of Halloween and probably the part kids most look forward too.  Going around the neighborhood in their costume collecting candy from all the neighbors is what people most associate with Halloween.  However, if you have a child with a nut allergy the candy part of Halloween can become a bit scary.  A lot of what ends up in your child’s trick-or-treat bag will either contain nuts or present a cross contamination risk.  You don’t want to have to take that joy of trick-or-treating away from your child.  They go through enough in life because of their nut allergy that makes them feel different, this doesn’t need to be one of them.

Making Halloween safe for your nut allergy child doesn’t have to be difficult, it just requires a little forethought on your part and a little imagination to make your child feel special and not left out.

If you are comfortable it is perfectly safe to continue to let your child trick-or-treating with his or her brothers and sisters and friends.  Set specific ground rules and make them apply to all your children.  Such as, no one is to eat, unwrap, play with anything they get in their trick-or-treat bag until they get home and you have a chance to examine it all (this rule should apply regardless of whether your child has a nut allergy or not).  Once your child gets home take their trick-or-treat bag and go through it.  Remove all candy that contains or may contain nuts.  Many parents with nut allergy kids do an exchange, for everything they take away they replace it with something that is safe.  You could also just have a trick-or-treat bag pre-made for them them and when they come home exchange they bag they have for the new safe bag.

There is plenty of Halloween candy that is safe for nut allergy kids.  Here is a list of a few I could think of (be sure to always read the label as some manufacturers may change their processes at any time):

  • Skittles (all varieties)
  • Most jelly beans
  • Anything made by Haribo
  • Hershey Kisses (except the peanut butter and almond varieties)
  • Full size Hershey Milk Chocolate and Krackle bars
  • Milk Duds
  • Hershey Kissables (great M&M alternative)
  • Rolos
  • Many Wonka products including; nerds, bottle caps, runts, gob stoppers, pixy stix and tart n tiny.
  • Smarties (rockets for my Canadian readers ;) )
  • Laffy Taffy
  • Tootsie Rolls and Tootsie Pops
  • Lifesaver Gummies
  • Whoopers (except the peanut butter variety)
  • Sweet Tarts
  • Sunmaid chocolate-covered raisins
  • Twizzlers
  • York Peppermint Patties
  • Red Vines
  • Jolly Ranchers
  • Starburst
  • Candy Corn (read label carefully)

Remember to always read the label carefully as not all varieties, particularly non-name brand versions can be manufactured in facilities that also manufacture nut products.

You will likely have to spend a bit more time in the candy aisle than most people because you’ll have to read labels carefully.  Luckily there are lots of options so you will be able to find several things to hand out for Halloween and to give to your child as an alternative.

Our plan this year, since Maya is still so young, is just to let her to a little trick-or-treating on our street and just keep what is safe.  She doesn’t need a lot of candy, so I figure what she is left with should work out just fine.  Once she is older I plan on doing the exchange with her by taking what isn’t safe and replacing it with something that is.

What tricks do you use to keep your nut allergy child safe on Halloween?

SunButter is a peanut butter alternative made from sunflower seeds.  I picked up a jar of SunButter to give it a try since my daughter is allergic to peanuts and tree nuts.  Both my husband and I love peanut butter so my goal was to find a product that would be a good substitute.  One that would mimic peanut butter well both in everyday use like on toast or on a peanut butter sandwich as well as in recipes like cookies or monkey munch.

Admittedly, I was a little skeptical.  I just couldn’t see how a product made without peanuts could really taste like peanut butter.  My first try of SunButter was on a peanut butter and jelly sandwich.  I was very pleasantly surprised.  SunButter tasted almost exactly like peanut butter.  The consistency was pretty similar to natural peanut butter and spread really well on the bread.  Now, I will admit that Maya wasn’t a huge fan but she can sometimes not be a fan of something the first time she tries it.  I’ll let her try a few more times before I say for sure if she likes it or not.

I think SunButter will be very useable as a peanut butter substitute in recipes.  Based on the taste and consistency I would imagine that SunButter can easily be substituted into baking recipes in the same quantities as the recipe calls for.  As with any substitutions it may take a little trial and error before you get the perfect amount.  I’m going to give it a try in monkey munch later this week so I’ll let you know how that goes.

My one big disappointment was the price.  I had to pay over $6 for a 1lb jar.  Now, I bet the pricing was high because the store I purchased it from saw an opportunity to gauge the consumer a little given that people looking for peanut alternative “peanut butter” don’t have a whole lot of options.  You can find it cheaper (about half the price) online at places like, Peanut Free Planet.

So, the bottom line is that price aside I am very impressed.  SunButter is definitely a peanut butter alternative that this admitted peanut lover could get used to.  If you have children with peanut allergies it is definitely worth giving this product a try.  I would recommend purchasing it online though as you will be able to get a much better deal!