Peanut Allergy in Children

Peanut Allergy in Children

Peanut allergy is one of the most common and potentially serious food allergies in children. Unlike many childhood food allergies, peanut allergy tends to persist into adulthood in the majority of cases. It is also one of the most common causes of anaphylaxis in children.

Dr Mugilan Anandarajan, Consultant Paediatrician with a special interest in allergy, provides expert assessment and management of peanut allergy for children aged 0–16 at Kingsbridge Private Hospital and Ulster Independent Clinic in Belfast.

Symptoms of Peanut Allergy

Peanut allergy symptoms typically occur within minutes of exposure and can include:

• Mild to moderate: Hives, itching, swelling of the lips or face, runny nose, watery eyes, vomiting, abdominal pain
• Severe (anaphylaxis): Throat tightening, difficulty swallowing, difficulty breathing, wheeze, drop in blood pressure, loss of consciousness

Even small amounts of peanut can trigger a severe reaction in sensitised individuals. Cross-contamination is a significant concern for children with peanut allergy.

Diagnosis of Peanut Allergy

Diagnosis is based on a detailed clinical history combined with allergy testing. Dr Anandarajan will take a thorough history of your child's reactions and recommend the most appropriate testing pathway.

Testing Options for Peanut Allergy

Skin Prick Testing

Skin prick testing with peanut extract is a fast and reliable test for IgE-mediated peanut allergy. Results are available within 15–20 minutes and the test is well tolerated by children of all ages.

Specific IgE Blood Testing

Specific IgE testing (including component-resolved diagnostics such as Ara h 2) can help predict the severity of peanut allergy and guide management decisions. Component testing is particularly useful in distinguishing true peanut allergy from cross-reactive sensitisation.

Supervised Oral Food Challenge

In some cases, a supervised oral food challenge may be recommended to confirm or rule out peanut allergy, or to assess whether a child has outgrown their allergy. This is performed under close medical supervision in a clinic setting.

Management of Peanut Allergy

Management of peanut allergy involves:

• Strict peanut avoidance and guidance on reading food labels
• Written emergency action plan
• Prescription of adrenaline auto-injectors (EpiPen / Jext) where indicated
• Training in adrenaline auto-injector use for parents, carers and schools
• Antihistamine prescription for mild reactions
• School and nursery allergy management letters
• Regular review to reassess allergy status

Emergency Treatment for Peanut Allergy

Children with a confirmed peanut allergy and a history of severe reactions should carry two adrenaline auto-injectors at all times. Dr Anandarajan will provide a personalised emergency action plan detailing when and how to use the adrenaline auto-injector, and when to call 999.

Parents and carers will receive clear guidance on recognising the signs of anaphylaxis and responding appropriately.

Peanut Introduction in Infants

Current UK guidance (BSACI) recommends early introduction of peanut in infants who are not at high risk of peanut allergy. For infants with severe eczema or existing egg allergy — who are at higher risk — specialist assessment before peanut introduction is recommended. Dr Anandarajan can advise on the safest approach for your child.

For further information, also visit belfastallergyclinic.com and belfastchildrensclinic.com.