Manage Your Child’s Care with MyChart
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 warning 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. It is common for children to
grow out of food allergies such as to egg, milk, or soy, but less
likely for people grow out of a peanut or tree nut allergy.
Most healthcare providers warn not to feed children highly
allergic foods, such as 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. You should look for the
following symptoms, which can be severe:
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. The reaction can cause
swelling of the mouth and throat, dangerously lower blood
pressure, and closure of the airways leading to trouble breathing.
This type of reaction calls for immediate medical attention. It is
treated with epinephrine (a medicine that is given by a shot).
Typically parents or caregivers of children that have severe
reactions to allergies carry their own injection kits in case of
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. Dietary
restrictions for those with peanut allergy are more difficult to
follow because so many processed foods and ethnic foods contain
peanuts and peanut products.
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. 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. 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
The first step is to be informed about all the ingredients that
indicate the presence of a tree nut. Reading labels and having an
awareness of ethnic and convenience foods that may not have labels
is key. If you are unsure, call the food manufacturer at the 800
number provided on the label. When in doubt, don't use the
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 one of the biggest problems when trying to
avoid nuts. It is common for nuts to come in contact with other
foods during processing and in preparation, even if the nut is not
included in the recipe.
The following foods are sometimes contaminated with nuts:
When dining out, always tell the waitperson about the allergy and
order simple dishes without sauces unless you're sure there are no
nuts present. Cross contamination can be a problem in restaurants.
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, so the challenge is not providing
adequate nutrition, but to keep your child from unknowingly eating
foods that contain them. You can prepare desserts from scratch or
mixes you know don't contain nuts. Some ice cream and chocolate
companies make products without nuts and that have been processed
separately from those prepared with nuts to eliminate the risk of
"cross-contamination." This would be stated clearly on the label.