Did you know that about 1 in 50 children has an allergy to nuts? For some children, consumption of a small amount of peanut can cause a severe allergic reaction.*

A nut allergy is a serious thing and is becoming more common in children. Many schools and camps have started to implement nut-free or nut-aware environments to keep kids with allergies safe. A nut-free or nut-aware environment may prove to make lunchtime a challenge for parents whose kids are PB&J fanatics.

So, what is safe to send, and what should be avoided when packing lunch for your child or sending in snacks? We checked in with Dr. David Morris, division chief of allergy and immunology at Dayton Children’s to get answers to the questions we all want to know.

what is the difference between nut-free and nut-aware?

Environments with a nut-free policy will typically enforce a ban on peanuts and tree nuts. This means nut products are not allowed on the premises, at all. While nut-aware environments will allow nuts on the premises, but heavily discourage them.

Nut-aware environments put a lot of effort into preventing cross contamination through proper handling of food and proper hygiene. They will usually have a nut-free table for children with an allergy to eat at during mealtime. Many districts have made these tables optional for the food allergic child.

what foods should be avoided if my child is in a nut-free environment?

Every policy may differ based on the type of nut-free environment needed by those with a severe food allergy. To be on the safe side it is generally best to avoid sending any type of peanut or tree nut with your child. This includes:

• Almonds
• Brazil nuts
• Cashews
• Chestnuts
• Hazelnuts
• Hickory nuts
• Macadamia nuts
• Pecans
• Pine nuts
• Pistachios
• Walnuts

how do I know if a food is nut-free?

The best way to be sure if a food is nut-free is to read the label and check the ingredient list. Foods sold in the Unites States are required to state on their labels if the food contains peanuts or tree nuts (per the Food Allergy Labeling and Consumer Protection Act of 2004). After checking the ingredients list, look on the label for phrases like “may contain tree nuts” or “produced on shared equipment with tree nuts or peanuts.” Foods with these warnings on the label may be consumed by children without food allergies as these are unlikely to cause reactions in food allergic children from cross contamination (when eaten by other children). Parents should check their specific school regulations.

other high-risk foods

When thinking about classroom treats or field trips, parents should read labels carefully. According to KidsHealth there are other high-risk foods for people with peanut or tree nut allergies because of potential cross-contamination that may not be mentioned on the food label.

• Cookies and baked goods. Even if baked goods don’t contain nut ingredients, it is possible that they came into contact with peanut or tree nuts through cross-contamination. Unless you know exactly what went into a food and where it was made, it’s safest to avoid store-brought or bakery cookies and other baked goods.
• Candy. Candies made by small bakeries or manufacturers (or homemade candies) may contain nuts as a hidden ingredient. The safest plan is to eat only candies made by major manufacturers whose labels show they are safe.
• Ice cream. Unfortunately, cross-contamination is common in ice cream parlors because of shared scoops. It’s also a possibility in soft-serve ice cream, custard, water ice, and yogurt shops because the same dispensing machine and utensils are often used for lots of different flavors. Instead, do as you would for candy, buy tubs of ice cream at the grocery and be sure they’re made by a large manufacturer and the labels indicate they’re safe.
• Asian, African and other cuisine. African and Asian (especially Thai, Chinese and Indian) foods often contain peanuts or tree nuts. Mexican and Mediterranean foods may also use nuts, so the risk of cross-contamination is high with these foods.
• Sauces. Many cooks use peanuts or peanut butter to thicken chili and other sauces.

what can my child pack for a nut-free lunch?

For starters, you don’t have to veer too far from your child’s love of PB&J. Try using a sunflower seed butter instead of peanut butter, almond butter or hazelnut spread. Your child probably won’t even notice a difference. Lunch meat is also a safe option if your child likes a little variety.

If sandwiches aren’t your child’s “jam,” below is a list of other healthy and safe food options your child could enjoy in a nut-free environment.

1. String cheese
2. Fruit: fresh, dried, freeze-dried, fruit leathers, dried fruit bars, fruit cups
3. Vegetables
4. Individual guacamole and hummus cups
5. Hard-boiled eggs
6. Yogurt cups/tubes
7. Cottage cheese
8. Meat sticks/jerky
9. Pretzels
10. Animal crackers

As a best practice we still recommend you always check a food’s ingredient label. One brand of a certain type of snack may be safe, while another may contain nut ingredients.

what is the future of nut-free schools?

In May 2021, new guidelines recommended against bans of specific foods including nuts. There is not enough evidence for or against site wide (nut free schools) bans. Concerns surround the impact of site wide food bans on the psycho-social well being of not only the children with food allergies but also children without these allergies. These impacts were measured against the mitigation of risks provided by site wide food bans. Unfortunately, there is not enough evidence that these bans prevent reactions. These concerns are what prompted the recommendation against the ban.

so what can parents do to help, now?

As stated, evidence for site wide food bans is low. Dr. Morris encourages parents to “stay tuned” as more evidence will be forthcoming. Until that time, he recommends the five tenets set out by the CDC in their voluntary guidelines for schools regarding food allergy:

1. Ensure the daily management of food allergies in individual children.
2. Prepare for food allergy emergencies.
3. Provide professional development on food allergies for staff members.
4. Educate children and family members about food allergies.
5. Create and maintain a healthy and safe educational environment.

Education about food allergy is important to help all our children (allergic and non-allergic) to thrive.

*Note: severe allergic reactions do not occur with only contact exposure.