Ask Dr. Marla: Can I use other nut spreads when the school has a no-nuts policy?

My kids’ school has a no-nuts
policy, but I thought kids with peanut
allergies are not usually allergic to
tree nuts. Can I use other nut spreads
like almond butter in my kid’s lunch?

Answer:

The short answer is No. Although peanuts
are a ground nut and a peanut allergy is
different from a tree nut allergy, there are
many similarities. In fact, many peanut
allergy sufferers also have tree nut allergies.

For more information, I turned to the
Food Allergy and Anaphylaxis Network.
According to the network, one study showed
that from 1997 to 2002, the incidence of
peanut allergy doubled in children. Peanuts
can trigger a severe allergic reaction.
Symptoms range from hives, eczema,
digestional discomfort to anaphylaxis, a
potentially fatal constriction of the airways
and swelling of the throat, known as
anaphylaxis.

There is also allergy to tree nuts, which
include, but are not limited to, walnut,
almond, hazelnut, cashew, pistachio, and
Brazil nuts. These are different than peanuts,
which are a legume, or seeds, such as
sunflower or sesame.

Peanut allergy or tree nut allergy are
usually considered to be life long. However,
recent studies indicate that up to 20 percent
of children with peanut allergy will
outgrow it the condition.

We usually advise children with peanut
allergies to avoid all nuts for two reasons:

• to prevent accidental peanut exposure
  (because people can’t reliably distinguish
  different nuts);
• because up to one third of peanut allergic
  children will later develop a tree nut allergy.

When we feel we are ready to know, we can
test individual nuts to be sure. But tree nut
allergy can also develop “out of nowhere” in
30- and 40-year-olds, so we can’t say someone
is safe forever. Depending on the age of the
child, testing for almond allergy might open
the door for almond butter (if it is peanut-free),
and negative hazelnut tests might lead
to eating chocolate hazelnut spreads such
as Nutella.

Many experts advise patients who are
allergic to some tree nuts to avoid peanuts
and other tree nuts because of the high
likelihood of cross-contact at processing
facilities, which process peanuts and different
tree nuts on the same equipment. Many nut
butters are produced on equipment used to
process peanut butter, therefore making it
somewhat risky. Further, a person with an
allergy to one type of tree nut has a higher
chance of being allergic to other types.

Originally published in ParentsCanada magazine, November 2012.