Peanuts or Tree Nuts for Children and Babies?

There is controversy about when to give a baby or young child peanuts or tree nuts.  Some doctors recommend introducing these foods at about one year.  Others suggest waiting until two or more years of age. Tree nuts include almonds, beechnuts, brazil nuts, cashews, chestnuts, gingko, hazelnuts, hickory nuts, macadamia nuts, pecans, pine nuts, pistachios and walnuts. Peanuts are not a tree nut--they are part of the legume family as are peas.

As a parent of two food-allergic sons, I am grateful that our sons’ allergist instructed us not to give them peanuts or tree nuts until at least five or six years of age.  I think the old adage, “An ounce of prevention is worth a pound of cure,” is perfect advice this situation. Our sons are now six and seven years old.  Both had a dairy allergy and egg allergy.  One year ago our youngest outgrew his dairy allergy.  Neither child has developed a peanut or tree nut allergy--probably because we haven’t given them any peanuts or tree nuts.

As a parent of allergic children, I remember feeling the angst of wanting to know if either son would be allergic to peanuts or tree nuts.  This “need to know” feeling was strong and the ambiguity bothered me.  The ambiguity also bothered me when I explained the situation to others.  For example, it was harder to respond to teachers when they asked, “Is he allergic to peanuts or tree nuts?”  My answer was and still is, “My sons don’t appear to have an allergy to peanuts or tree nuts but we haven’t given them any nor do we plan to until they have fully outgrown their other allergies to dairy and egg.”  We’ve kept them in peanut and tree nut free classrooms, although they are allowed to sit next to others at lunch who may be eating peanuts or tree nuts.

Normally I don’t get to explain the details behind our avoidance: Our allergist explained and my research has demonstrated to me that a child who develops food allergies can have an immature or problematic digestive system.  For instance, if the child has taken a lot of antibiotics during their young life then the bacteria which normally reside in the child’s digestive track, a.k.a. intestine, can be destroyed.  When it isn’t replenished through probiotics (like acidophilus or many other strains), the intestine wall can actually become damaged to the point where tiny holes are created in it.  This is called ‘leaky gut syndrome’ and can be very difficult to diagnose (and see).  But one negative result is that food particles can leak through the intestine wall without being properly digested.  Then the liver must cleanse the blood of these particles and sometimes the immune system creates antibodies to attack them.  Once the antibodies are created the allergic reaction is in place.

Since our sons had food allergies (to dairy and egg) we were extremely wary and afraid of introducing peanuts or tree nuts since the likelihood was high that an allergic reaction would be created.  So we waited, and waited, and waited.

Only once our younger son outgrew the diary allergy just after his fifth birthday, did I give him a peanut.  When I did, I made sure it wasn’t dry roasted, since those are cooked at such a high temperature that some believe changes the protein and contributes to the creation of a peanut allergic response.  An other option would have been to give him boiled peanuts, which are more common in China, and where they have a lower allergy rate to peanuts.  Dry roasted peanuts are cooked at temperatures around 400 to 500 degrees.  Water boils at around 200 degrees--a substantially lower temperature.  Because I had a hard time finding either natural, raw or boiled peanuts, even at our local natural foods store, I purchased a box of “natural, organic, raw” peanuts over the Internet from a state across the county.  When they arrived, I gave him one-half a peanut each day for several days until I was sure he could tolerate them.  I still haven’t tried tree nuts.  As for my older son who is now seven and one-half, we have not given him peanuts or tree nuts, because his dairy and egg allergy remain present. 

Our caution in exposing our sons to peanuts and tree nuts even took place in the allergist’s office.  When they were skin prick tested we opted not to have the peanut or tree nut allergen injected into their skin because we didn’t want to expose them to the protein via skin,  Could this possibly trigger an allergy?  Some say yes, others say no.  But being the parent of the beloved child, why throw caution to the wind and give it a go?  No, we prefer the saying, “Better safe than sorry.”  So we had our sons tested for peanut and tree nuts using the ELISA or RAST blood tests when they were about three or four years old.  All blood test results came back negative for allergy to peanuts and tree nuts.  But we still didn't give them either of these foods.

So our life continues at ages six and seven with avoidance of peanuts and tree nuts.  Our riskiest behavior will involve occasionally purchasing food that was manufactured in a facility that creates peanut or tree nut products.  But for the most part we try to avoid that as well.  We will wait until there is evidence that each of our sons’ digestive systems are healed and immune systems are less likely to attack protein particles before taking the next steps. 

As a mother and researcher of food allergies, I personally think that if a child has other food allergies when they are babies, such as an allergy to wheat, soy, egg, fish, dairy or any food, then that child shouldn’t be given the dangerous allergy-foods of peanuts, tree nuts or shellfish until they are older (5+) and have outgrown all of their other allergies.  As for children without allergies, I’d still wait until the child was at least three or four to introduce peanuts or tree nuts.  My two cents.

Food Allergies can cause Eczema

When my first son was born he had cradle cap─patchy pieces on his scalp which I tried to oil and wash off painstakingly. He also developed a rash on his stomach, then on his arms and legs. I creamed this using a prescription cream from the doctor. Had I known better then I’d would have stopped eating and drinking dairy products─as he turned out to have a dairy allergy that has lasted for seven years thus far. I breastfed him and believe that the protein from dairy irritated his body. I often also wonder what other kind of discomfort it caused him. Did it give him cramps? Gas? Make him cry more? I finally figured out he had a dairy allergy and removed all dairy before he was a year old. His eczema was greatly reduced though his skin was still a bit dry, especially in the winter. Now, for the past year, since introducing fish oil into his diet, his dry skin isn’t a problem at all. We occasionally use a little cream, but mostly just on his hands and only in the winter.

I’ve heard friends talking about the oozing red rash behind their child’s elbow or knee. Or they talk of the variety of creams they’ve tried. One of the mothers interviewed in my book was so adamant about finding the cause of the eczema or rash on her infant that kept him and her up at night for weeks from the probable burning and itching feelings that she asked herself and her doctor over and over until she found the solution herself. She found her son was allergic to dairy by removing it from her own diet and seeing his eczema “clear up by ninety percent,” in her words. Sometimes the discovery can take place by accident. In Robyn O’Brien’s book, The Unhealthy Truth, she discovered her son’s eczema cleared up when they went on vacation and he didn’t drink the many cups of milk that he normally consumed. Upon returning home and to his old habits, the eczema returned, as well as his cough and earaches. Eventually Robyn weaned him from milk, yogurt, cheese and other dairy products, which healed him.[1]

Over the years, I read a lot about itchy, red, bumpy rashes to try to understand why eczema and food allergies are created. I developed the following layperson’s understanding: Eczema is caused by the inability of the infant’s immature digestive system (or a child's or adult's digestive system) to digest certain proteins, such as the dairy proteins, which can be hard to break down. These hard-to-digest proteins travel through the digestive system and go into the blood stream undigested. The liver then tries to cleanse the blood stream of this undigested protein. This works for a while, but then the liver becomes overloaded and cannot clean the bloodstream sufficiently. As a result, the immune system comes to the rescue and builds antibodies to attack the foreign proteins. Once the immune system creates antibodies, the allergic reaction is in place. The immune system’s antibodies tell the body to attack that foreign substance as if it were a virus or disease, which can cause the body to go into overdrive, possibly resulting in anaphylactic shock, or less severe yet equally devastating delayed allergic responses that can contribute to asthma, ADHD or autism. In the meantime, this foreign substance still needs to be excreted from the infant’s body, so the skin is used for excretion rather then the digestive system. Thus the skin becomes the cleanser of the body and shows a rash as the foreign substance comes out.[2]

I am sure that other things can irritate the skin. Environmental factors such as pets, dust mites, pollen can all contribute and make eczema worse, not to mention that there are other unrelated rashes caused by things like poison ivy─my worst nightmare. But I think people often overlook the fact that much of eczema can be caused by the food allergies to dairy, eggs, wheat, soy, peanuts, tree nuts, fish and shellfish. No matter how old you are or your child is, it can be a worthwhile experience to try to eliminate on of these foods for a week and see what happens. If nothing seems to change, try eliminating a different food for the next week. You may be pleasantly surprised at what problems you can solve without any medication or cost.

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[1] Robyn O’Brien, The Unhealthy Truth, Broadway Books, NY, 2009, p 147-150.

[2] A. Anderson, Flourishing with Food Allergies, Papoose Publishing LLC, CT, 2008, p. 35.