Among food allergens, peanuts are one of the most common for children. An allergic reaction occurs when the body’s immune system identifies a protein in the food as an allergen and produces antibodies to it.
These antibodies then attach to various cells in the body including those in the lungs, skin and gastrointestinal tract. When the body is exposed again to the food, the cells react and cause symptoms such as itching, swelling, hives, diarrhea, wheezing and potentially difficulty breathing (anaphylaxis). Allergic reactions to peanuts can be fatal so it is important to meet with the family to know specific needs and concerns. Children with severe peanut allergies often wear an identifying bracelet and have an epinephrine (epi) pen on hand in case of exposure. Staff should be trained on the use of the epinephrine injection so they will know how to respond in case of emergency.
Some centers and caregivers have chosen to eliminate peanut products altogether if there is a child with a severe allergy in their care. Another option might be to create "peanut free" zones with separate tables for children who are eating foods containing peanuts. The American Academy of Allergy, Asthma, and Immunology has downloadable signs to place on tables identifying them as peanut free.
Educating staff and food service personnel about awareness is extremely important. Emphasizing the need to read labels and to avoid cross contamination is critical for preventing exposure. If there is any doubt that a food may contain the allergen, it is best not to serve it.
Sometimes people confuse food allergies with food intolerances. An allergic reaction involves the immune system whereas a food intolerance, such as lactose intolerance, generally involves symptoms in the GI tract such as abdominal cramping, diarrhea, nausea and vomiting but there is not a risk of anaphylaxis.
How to avoid peanuts or peanut products
Children will often outgrow food allergies in adulthood, but in the meantime, it is important to follow safe procedures to prevent reactions from occurring. Here are some key actions to follow:
- Always read food labels for ingredients. Do not assume the food is free of an allergen. Check to make sure.
- Keep in mind that ingredients in store-prepared foods can change weekly so it is important to check.
- Avoid products that are not labeled or that may be imported and could contain unknown ingredients.
- Avoid foods from bulk bins due to the risk of cross contamination.
- Make sure that children who have eaten foods containing peanuts wash their hands after eating and do not have any food residue on their faces before coming in contact with the sanitize the area where they have been eating so that there is no residue left on the surface.
Food preparation tips
- Wash hands before AND after handling foods, especially those containing peanuts.
- Clean and sanitize the food prep area including utensils, equipment, and anything that touches food.
- Avoid cross-contamination by using separate utensils and serving dishes for peanut containing foods. It is not enough to wipe a utensil clean since even food residue can cause a reaction. Check to see if foods have been prepared in a facility where cross-contamination may have occurred. Food labels are required to state this if it is a possibility.
- Store peanut-containing foods in a separate area of the refrigerator and pantry.
Nut-free soft granola bars
- 3 cups rolled oats
- 1/2 cup brown sugar
- 1/4 cup wheat germ
- 1/2 cup margarine
- 1/2 cup corn syrup or honey
- 1/2 cup chocolate chips or raisins (or both)
In a large bowl, combine oats, sugar, and wheat germ. Cut in margarine until mixture is crumbly. Stir in corn syrup or honey. Mix well until combined.
Stir in chocolate chips/raisins. Press into greased 9" square pan. Bake at 350°F for 20 to 25 minutes or until golden. Let cool for 10 minutes, and then cut into bars.
NOTE: Avoid ingredients purchased from bulk-food bins, or foods not labeled.
After making these granola bars, you may want to read the story The Peanut Butter Jam, by Elizabeth Sussman Nassau, ISBN 092917335, published by Health Press for ages 4-8. It tells an interesting story of a young boy who is allergic to nuts, and his experience on the day the children made peanut butter bird feeders.
Peanut-free snack alternatives
- Air-popped popcorn
- Bean dip
- Beef jerky
- Bread sticks
- Celery stuffed with cream cheese
- Cereal and pretzel mix
- Cold pizza
- Fresh fruit
- Hard boiled eggs
- Milk puddings
- Mini-pitas stuffed with cheese
- Oatmeal cookies
- Pancakes and waffles
- Pepperoni sticks
- Pickles, olives
- Refried beans
- Rice cakes
- Sliced ham or turkey rolled around a cheese stick
- Vegetables with dip
- Yogurt
Dietary cautions
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Be aware of choking risks and food allergies when preparing and serving meals and snacks. Think about the size, shape, and consistency when choosing foods due to the potential choking risks in children. Food cut in large chunks, small hard foods, and soft and sticky foods should be avoided. The top choking hazards for children include: hotdogs, meats, sausages, fish with bones, spoonfuls of peanut butter, popcorn, chips, pretzel nuggets, raisins, whole grapes, raw carrots, fruits and vegetables with skins, and marshmallows. Be sure that food is cut in small pieces (no larger than ½ inch), grated, or finely chopped. Be sure that children are closely supervised when they are eating.
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Do not give honey to children under 12 months of age. Honey contains spores that can cause infant botulism.
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Many children have food allergies or sensitivities to food. According to the American Academy of Pediatrics, 90% of children's food allergies are from milk, eggs, peanuts, tree nuts (pecan/walnuts), fish, shellfish, strawberries, soy, wheat, and gluten. Carefully read food labels for potential risks and be sure to ask the parents if children have a known allergy or sensitivity.
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Dental health is a growing concern with young children, so it is important to keep in mind that starchy, sticky, and sugary foods can cause tooth decay. Children should brush their teeth after any meal or snack, but particularly when you serve these foods.
Academy of Nutrition and Dietetics http://www.eatright.org/Public/content.aspx?id=5539
National Institute of Allergies and Infectious Disease http://www.niaid.nih.gov/
Lunches & Snacks 7-1
