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Allergy Specialists
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Peanut and tree nut allergy

Allergic reactions can be triggered by a wide range of foods. Theoretically almost any food may be implicated, but the most common culprits are peanuts and tree nuts. Tree nuts include cashews, almonds, Brazils, hazelnuts, walnuts, pecans and pistachios. About three-quarters of children allergic to nuts or peanuts will react on their first exposure.

Peanut allergy causes more problems than other food allergies because it is common (1 in 50 infants), exposure is hard to avoid and in some cases even trace amounts can trigger symptoms. 

Peanuts are actually legumes. A small percentage of people with peanut allergy react to other legumes, such as peas, beans and lentils. Care is needed, but most will find they can tolerate these other legumes without problems.

More commonly, people with peanut allergy react to tree nuts. Hence, doctors often advise people with peanut allergy to avoid tree nuts, and vice versa.


The majority of allergic reactions to peanut and tree nuts are mild. Contact hives, eczema and vomiting are the most common complaints. Some sensitive individuals develop difficulty breathing due to asthma or throat swelling, or a drop in blood pressure. This is known as anaphylaxis, and allergy to peanut or tree nuts is one of the most common triggers. 

Is it life-long?

Peanut allergy was once thought to be life-long in all cases. But recently it has been shown that about 20 per cent of young children grow out of their peanut allergy by the age of five. Any five-year-old who has been free of peanut allergy symptoms for more than a year may possibly have outgrown the allergy. The child can be referred to an allergy specialist for “challenge testing”, in which peanuts are introduced to the child in a controlled way. This will be carried out in a hospital setting.
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Peanut, tree nut and seed allergy
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Avoiding tree nuts
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Eating out


Teenagers and young adults may be more at risk of life-threatening reactions than younger children — and this is more to do with risk-taking behaviour. But their allergies can be well managed so long as they always carry prescribed medication, learn how to use it, and are extremely vigilant when food is around. It is important that children take age-appropriate control from an early age, and you can learn more about this from our Letting Go booklet.


Contrary to their name, coconuts are not tree nuts but are monocotyledonous plants of the palm family Arecaceae. Nut bearing trees, on the other hand, are dicots and are only distantly related to the palm species. Coconut rarely causes allergy. Most allergists will not suggest coconut avoidance unless there has been an allergic reaction to coconut.


If you are travelling on an international flight, check that they do not serve peanuts as a snack as the airborne particles may cause a reaction. The most likely cause of reactions in flight, however, is through eating peanuts or nuts present in airline food. This is solved by playing it safe and taking your own food on the plane.

Acknowledgements: Dr Jan Sinclair — Paediatric Immunologist, and Jennifer Heyward  — Paediatric Dietitian, of Starship Children's Health, and the Anaphylaxis Campaign.