More children have peanut allergies than ever before—learn the signs of a peanut allergy, what to do if your child is allergic and new recommendations of when to introduce baby to peanuts.

According to a 2013 study from the Centers for Disease Control and Prevention, between 1997 and 2011, food allergies among children rose approximately 50 percent. The study also showed that the number of kids in the U.S. with a peanut allergy—the most common cause of food-induced anaphylaxis (a sudden, life-threatening form of allergic reaction)—increased threefold, from .4 to 1.4 percent.

Know the Signs of a Peanut Allergy

So what does a peanut allergy look like and what should you do if you suspect your child has one? “Though peanut allergies can manifest at any age, typically a child who is allergic will experience hives, swelling, nausea, vomiting, abdominal pain, and/or have trouble breathing within 15 minutes to an hour of ingesting the nut for the first time,” explains Roper St. Francis affiliated allergist John Ramey. If these symptoms are severe, seek medical help immediately; regardless of symptom severity, make an appointment with an allergist, who will perform both a skin prick and blood test to check for the allergy.

What to Do If Your Child is Allergic to Peanuts

If diagnosed, it’s all about avoiding the nut—along with a few others. “People with peanut allergy may also have reactions to tree nuts such as cashews, walnuts, pecans, and almonds,” says Dr. Ramey, who recommends that parents carefully read all food labels, even for items like soups, salad dressings, and cereals. “If it says the food might contain peanuts or tree nuts, or if the food was processed in a factory with nuts, don’t take the risk.” Alert your child’s teachers, coaches, and counselors of the allergy, as well, and in cases of accidental ingestion use an injectable form of epinephrine and call 911 immediately.

Lastly, follow up with your child’s allergist every few years. “We like to re-test to see if there’s been any evidence of improvement,” says Dr. Ramey. “There’s a roughly 20 percent chance that a child grows out of the allergy.”

New Guidelines on When to Introduce Peanuts to Your Baby

Doctors may never be sure what caused the spike in peanut allergies, but there’s a leading hypothesis. “For several years, the recommendation was to not introduce peanut products until a child turned three,” says Dr. Ramey. “But it was during that time that we saw the prevalence of the allergy rise.” In January, the National Institute of Allergy and Infectious Diseases released a new set of guidelines, recommending that babies be introduced to peanuts at a younger age. Here, Dr. Ramey shares the new guidelines:

• Infants with a higher risk for peanut allergy (risk factors include having eczema, asthma, a sibling with the allergy, or an egg allergy) should visit an allergist before consuming peanut products.
• Children with no risk factors can try peanut products at any point within their first year.
• Babies should never eat peanuts as they pose a choking hazard. Instead, peanut powders can be added to liquids or a small amount of peanut butter can be served.
• When introducing new foods, especially nuts, offer a small spoonful and watch for potential reaction symptoms. If none occur, increase the amount the following day.
• Never introduce multiple foods at once—if your child does have a reaction, you’ll be able to better identify what caused it.