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Understanding Tree Nut Allergies

April 04, 2022 4 min read

Similar to peanuts, tree nuts are found in many well-loved foods, for both children and parents alike.

But with rising allergy rates, tree nuts have been identified as one of the nine most common food allergens in the United States. A tree nut allergy not only affects your child's nutritional health but can have rippling effects on their quality of life, from living in fear around food to feeling restricted in their daily activities. 

That’s why at SpoonfulONE we’re on a mission to fight these rising rates. Ready to learn more? Here’s what parents need to know about tree nut allergies.

How Common Is A Tree Nut Allergy In Babies?

A tree nut allergy is one of the most common allergies among children and adults, affecting up to 2% of children. There are six tree nuts most reported to cause allergies among children and adults, which include walnut, almond, hazelnut, pecan, cashew and pistachio. 

And every year, food allergy rates are increasing. The CDC reports that the prevalence of food allergies in children has increased by 50% between 1997 and 2011, with as many as 6 million children in the United States developing some form of food allergy.

What Does A Tree Nut Allergy Look Like?

Affected by both genetic and environmental factors, a food allergy occurs when your child's immune system decides that a certain food is a "danger" to their health. Their immune system starts sending out immunoglobulin E (or IgE) antibodies that react to the food and cause an allergic reaction.

Tree nut allergies, along with peanuts and shellfish, are one of the most common causes of severe allergy attacks, where exposure to even tiny amounts can cause fatal allergic reactions.

Most food-related allergy symptoms occur within minutes of eating or being exposed to tree nut proteins, but allergic reactions can still occur within 2-4 hours of ingestion. Signs that your baby has developed a tree nut allergy may include:

  • Stomach distress including vomiting, cramps, indigestion, or diarrhea
  • Difficulty breathing, wheezing, or shortness of breath
  • Repetitive cough, hoarse voice, or tightness in the throat
  • Hives, red skin, or swelling around the face, mouth, or tongue
  • Confusion, dizziness, or loss of consciousness
  • Weak pulse
  • In rare cases, anaphylaxis

If your child has shown a reaction to tree nuts, you should have your pediatrician test for a food allergy. Common testing methods include a skin prick test, IgE testing, and an oral food challenge. 

Long-Lasting Effects Of A Tree Nut Allergy

Research shows children with one allergy are more likely to develop another food allergy. In the case of tree nuts, there is a 50% likelihood that children who are allergic to one tree nut will be allergic to another tree nut. For example, there are high rates of those being allergic to cashew or walnut reacting to pistachio or pecan, respectively. 

Though tree nuts are different from peanuts, which are a legume, one study shows that about 40% of children with a tree nut allergy will also show symptoms of a peanut allergy. 

Tree nut allergies are also known to be lifelong, with only 9% of children outgrowing this allergy. And if your child is allergic to more than one tree nut, they are even less likely to outgrow their tree nut allergy. 

Aside from being more likely to develop further food allergies, studies have also shown that children with a food allergy are two to four times as likely to develop other allergic conditions, such as asthma or eczema.

How To Manage Tree Nut Allergies

Tree nuts can be found in surprising places, such as natural flavorings, candies, sauces, and cereals.

With the possibility of severe allergic reactions, it is essential to eliminate all sources of tree nuts and tree nut products from your little one’s diet if they have been diagnosed with this allergy. Even exposure to trace amounts of nut proteins can cause a serious allergic reaction. For that reason, a pediatrician may also recommend you avoid all peanut products as well due to cross-contamination during the manufacturing process.

If your child is allergic to tree nuts, they will need to avoid all related products, often found in many common foods such as:

  • All nuts, including walnuts, almonds, hazelnuts, pecans, cashews, pistachios, Brazil nuts, macadamia nuts, pine nuts, and hickory nuts
  • Nut extracts, pastes, butters, oils, flours, and milks
  • Cereal and granola
  • Crackers and trail mix
  • Cookies, desserts, and baked goods
  • Candy and chocolates
  • Marinades and sauces 
  • Baking mixes
  • Grain breads
  • Ice cream
  • Pudding
  • African, Asian and Mexican cuisine, where tree nuts are commonly used 
  • Walnut and almond are also sometimes used in personal care products

Though the FDA has also classified coconut as a tree nut, coconuts are actually a fruit and can often be eaten without reaction. That is similar to shea nuts, which usually don’t present symptoms. Before introducing, speak to a pediatrician.

As one of the nine most common allergens, U.S. federal law labeling on packaged food for 18 different varieties of tree nuts.  However, it is voluntary for a manufacturer to state if there may be potential cross-contamination as tree nuts and peanuts are often produced using the same equipment. Read ingredient labels closely, and pay close attention to phrases such as “may contain tree nuts” or “made in a factory that uses nut ingredients.” If you have questions, do not hesitate to contact the manufacturer.

How To Avoid A Tree Nut Allergy In Babies

We know that no parent wants to see their child suffer from food allergies, but unfortunately, there is no guarantee that they can be avoided. 

However, there is still hope. Groundbreaking clinical studies, like LEAP and EAT, have taught us that babies who were given potentially allergenic foods as a regular part of their diet were less likely to develop a food allergy. 

According to the AAP and the USDA’s latest guidelines, you can (and should!) start introducing allergenic foods, like tree nuts, to your baby alongside other solids. In fact, experts now consider it safe for your child to start allergen introduction as early as four months, rather than later in life. 

At SpoonfulONE, we believe regular, consistent exposure to common allergens in the diet throughout early childhood is key to staying healthy.