Pros/Cons to skin test for 6 mo old

[mamak05]

Hello,

My 6 month old DD has had some severe eczema flare ups since age 2 months. I've been working through my diet (she is EBF) and other possible causes and we are also seeing a naturopath.

A NP at our pediatrician's office saw baby's face during one of her severe flare ups and immediatly wrote a referral for skin testing. I realize we can get false positives/negatives etc, but what are some of the other pros/cons to doing this type of testing?

I'm trying to decide if it is the right thing for us to do and would love some perpectives from those who have had more experience than I do with this.

Thank you,
Kathryn

[kjbrown92]

I thought when there was a lot of eczema, that they preferred to do RAST because the skin is already inflamed. I think you're more likely to get false positives than negatives on the RAST though. They say that they're not that accurate (either of them) under 2yo. The other thing is that eczema can also be from environmental triggers so you could test for that (though it's more unusual with a baby that young). And it could be from food intolerances, meaning it won't give you any information at all. I did it with my kids to rule out allergies. I had DS tested when he was about 6 months old for milk; allergist said, nope go home and drink milk which I did, and DS started throwing up again for the next 3 days. I also had DS and DD2 tested when they were older to rule it out for a bunch of foods. So that I knew I was left with food intolerances.

[emilysmama]

When my dd was 2 mo, she developed persistent exzema that wouldn't go away. It was just a small patch, but none of the creams, lotions, or topical medications made it go away. At 6 mos, we were referred for skin testing. I agonized about it for a long time, then we took her in at 9 mos. It revealed allergy to environmental factors, but negative on food allergies. Baby was still exclusively breastfeeding, and several allergists said it shouldn't matter what I ate, but the allergist giving the allergy test suggested I try the elimination diet, but I didn't. That same allergist also suggested starting allergy shots right away, but I didn't. Everything stayed the same, and nothing changed.

In retrospect, I wished that I had at least kept a food journal of the foods that I ate and eliminated dairy from my diet, just to see what would happen, because I think it might have made a big difference. I didn't figure out that my dd shouldn't have dairy in her diet until she was 3 years old.

I didn't find the allergy test helpful, but perhaps you will. I think I would have found a food journal of lactating mother's diet helpful, and dairy isn't that hard to eliminated on a trial run.

[balancedmama]

I think it can be helpful because it is just one more piece of information to help you determine the cause of the allergies. Especially with an EBF baby - it can be hard to track down everything. I think the most significant downside is that the test just may not show anything. Even my son still has negative skin tests - no reaction, but if he eats or touches a trace of soy or egg he has a strong reaction. SO obviously he is allergic, but his skin doesn't prove that. I think the allergist said about 20% of kids his age will have a negative test when they are still allergic.

As far as having eczema and that creating a false positive...I don't think that's the case. That's why they do control pricks. One that is just water and one that is straight histamine to see how the skin reacts to those in comparison.

Concerning the downsides - both of my kids did extremely well w/ the tests when they were little. It is only now that they are older that they are more bothered by the pricks and itching. I've had it done myself,and I'd say from personal experience with my DD - skin testing was much less dramatic than trying to get a blood draw from her for RAST (which we were unsuccessful at, TWICE ).

[mamak05]

Thanks to all who have responded. I appreciate the perpectives you've shared! I'm kind of leaning toward doing it, just to see what results we do get as I try to puzzle this thing out.

[emilysmama]

I guess I would have to agree with balancedmama's reply. If the test reveals anything, then that could be useful. However, if the test is negative, don't make the mistake that I made and assume that no food allergies are involved and that the tested foods are safe.

[BirthKathy]

My son is 10 months, and has bad eczema mostly on his face, some on his body.

We see a Naturopath who had us do an ALCAT food intolerance test (uses blood). That found food intolerances which seemed to match up to my diet pretty well. None of the big allergens showed up, so the doctor suggested that we do an IGE test by Quest (also blood test). We had that done, and my son was negative for all environmental triggers except Dog and Cockroach, but positive for most of the food panel (peanut, walnut, milk, soy, wheat, corn, and sesame). These results also correlated with my food diary pretty well. Because there were so many positive results, I wanted to test for more IGE reactions before introducing more solids to him.

The Quest test was several hundred dollars for just 12 foods, so we found an IGE test through USBiotek that does IGG and IGE testing on 96 foods for about $350. We are doing an expanded panel that includes 111 foods. My doctor got an account with USBiotek so that we could order the test, but you can also order it yourself through DirectLabs. We had the blood drawn last week and are now waiting for the results. While waiting for all these tests, I eliminated most of my foods and then started re-introducing them. I got too mixed up a few weeks ago, so we are now back to a total elimination diet. My son is improving, but it's slow. We want to get him to baseline so that we can see reactions more clearly without them being on top of already damaged skin. I feel like he's probably having slight reactions to the elimination diet now that we've been on it too long.

So anyway, in response to your question, I feel that the testing we did has been worth it because we found that environmental issues are probably not the issue (though we're still very careful), and that food probably is. Just having that information is helpful. I also can definitely correlate many of the "bad" foods from both his tests to reactions. I have been keeping a food diary for 6 months now. It's hard to figure out what's going on with new reactions, but once we peg a food, I can go back and identify the reactions to previous exposures.

I am very hopeful about the new test results and our pending food re-introductions. Here is an article from USBiotek about a little girl with bad eczema on her face and body.

http://www.usbiotek.com/Downloads/ne.../USBNLv005.pdf

I'm not sure why the doctor did not recommend skin testing - possibly because that would have meant a referral to an allergist. The blood draws are a little tricky for little ones. My doctor couldn't get the blood draw the first time, so she referred us to Children's Hospital. I have been going to a guy there each time who is able to do it. Once I found him, I always ask for him when we go back. He said that it's hard because the veins move around when they're still little.

When I get the the USBiotek test results, I'll post them and what we think about them for your information.

[mamak05]

Thank you, Kathy, for sharing your experience so far. I hope you all find some relief and get some info from those tests! I look forward to finding out what happens!
Best,
Kathryn

[BirthKathy]

Test Results and whether it's helped

Hi Kathryn,

We have had our USBiotek results back for a couple of weeks now, and I wanted to give you an update. The results vary from our other two tests some. With the two IGE tests combined, my son is highly IGE allergic to every nut they tested for plus peanuts, soybean, all dairy, flaxseed and sesame. One test found mild IGE to wheat and corn, and the other said no.

The intolerances are different on the USBiotek than on the ALCAT. For the past week, I expanded my elimination diet to include some of the foods that tested zero reaction on both tests. My son did well during the week (slowly inching toward baseline), and I feel that it's time for us to eat a more varied diet and go ahead and trust the results that we've gotten.

So I used the three results to create a rotation diet for us to try. USBiotek's rotation diet allows the same food every four days, and the same food family every other day. That made it easier than ALCAT's plan of each food family every four days. I used all the foods with a mild reaction or lower and I was able to create a diet with plenty of choices. I had to put olive oil on two days and coconut oil on two days because there weren't any other good oil products tested for. I also chose to put egg every other day since my son is currently eating eggs daily with no problem. I'm going to test each "day" for a week before starting the rotation.

So anyway, I'm thankful for the results that we have. I hope that he grows out of these allergies, but for now the test results will really help us to avoid many foods that may be affecting his skin.

Out of the three tests, the USBiotek was the best deal and the most inclusive, so if you decide to test, I highly recommend it. It was 96 foods IGE and IGG. Adding the 15-food vegetarian panel was valuable to us - we had a lot of reactions there.

Let me know how your daughter is doing!