What you need to know about peanut allergies

by Eric Samuel, MD, family medicine
Tufts Medical Center Community Care

Dr. Eric Samuel in an exam room

Peanuts and peanut allergies have taken center stage in a new debate prompted by a local minor league baseball team.  The Hartford Yard Goats of the AA Eastern League recently announced their bold decision to make their ballpark, Dunkin’ Donuts Field, peanut free beginning with the 2019 season. The decision raised a few eyebrows among baseball purists who feel that the tradition of buying peanuts and Cracker Jack are as much a part of the game as balls and strikes.

“This is a pretty dramatic step to take, but we can certainly understand the reasoning behind the ban,” said Tufts Medical Center Community Care family medicine physician Eric Samuel, MD. “For a child with a peanut allergy, a trip to a ballgame can result in dire consequences.”

According to Dr. Samuel, the number of people with food allergies has increased dramatically over the past 10 to 20 years. In 2007, nearly three million children had known food allergies, but that number almost doubled by 2017. “In the US, we see nearly 10,000 hospitalizations each year due to food allergies,” said Dr. Samuel.

In 2007, nearly three million children had known food allergies, but that number almost doubled by 2017. Click To Tweet

“Although we can’t exactly pinpoint the reasons for this rise, we know that overall there has been some reluctance for parents to introduce young children to many foods that are thought to result in allergic reactions.”

The landmark Learning Early About Peanut (LEAP) study, conducted by the Immune Tolerant Network and published in the New England Journal of Medicine in 2015, is helping to change attitudes by showing that introducing peanuts to children at ages as early as 4 to 6 months can help to build an immune response and decrease their chances of developing a peanut allergy by as much as 80%.

Of course, if there is some concern that an allergy may exist, it is best to introduce foods in conjunction with and under the watchful eye of a physician. Together you can come up with a strategy to add and eliminate certain foods from your child’s diet. If an allergy is suspected, there may be some further evaluations such as skin or blood tests to confirm if an allergy exists.


Peanut allergies are among the most common causes of severe allergy attacks, and the symptoms can be life-threatening. Being able to identify signs and symptoms quickly can be important during an attack. They may include:

  • Runny nose
  • Hives or rashes
  • Stomach issues such as nausea, vomiting or diarrhea
  • Itching, tingling or tightening around the mouth and throat
  • Shortness of breath

A life-threatening reaction, called anaphylaxis, can also occur. During anaphylaxis, the throat may swell, constricting airways and making it difficult to breathe. There may also be a rapid pulse, drop in blood pressure, dizziness or even loss of consciousness.

“When anaphylaxis occurs, it requires immediate medical attention and treatment with epinephrine such as EpiPen or Symjepi,” said Dr. Samuel.

Peanut allergies are among the most common causes of severe allergy attacks, and the symptoms can be life-threatening. Click To Tweet

Be prepared

“Peanuts are different from some other foods that cause allergic reactions because of the dust created when shelling a whole peanut,” said Dr. Samuel.  “In an area such as a ballpark, imagine how the dust can fly on a windy day if the fan seated in front of you is shelling peanuts. Inhaling that dust or having it land on your skin can trigger allergic reactions.”

If you or your child has a peanut allergy, the only way to prevent a reaction is to avoid peanuts and peanut products entirely. Since that can be difficult in day-to-day activities, follow these steps.

  • Read the labels. Manufactured foods are required to clearly state whether foods contain any peanuts or were produced in factories that also process peanuts.
  • At restaurants and social gatherings, you are at risk of being exposed to peanuts accidentally. If you have doubts or concerns on an item, feel free to pass.
  • Be prepared for a reaction. Carry emergency medications with you at all times.
  • Team up with your doctor. It is important to work closely with your pediatrician or physician. Build a plan and have open and frequent communication.

Eric Samuel, MD, is a family medicine physician at Tufts Medical Center Community Care practice in Stoneham. For more information or to make an appointment, please call 781-338-7400.

Tags: allergies, baseball, children, Eric Samuel, family medicine, peanut, peanut allergy, primary care

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