going to the allergist - have questions

[sunnylady303]

My 14 month old dd is going to the allergist next week. She can't seem to tolerate wheat or dairy and gets gassy and can't sleep. What are they likely to do to her? Are there things I should know about allergies? I am totally ignorant and don't know where to start. I don't want to just unquestioningly let them do whatever tests to her or give her medication or anything, KWIM? Any advice or previous experiences with allergists? Thanks!

[Missy]

Hi!

It's definitely a good idea to see an allergist. Much of the appt will probably seem very much like a visit to the ped. You will probably be asked to give your family's health history several times, they'll weigh and measure your daughter, take vitals, check heart and lungs as well as ears, mouth and nose. Then, I assume they'll be testing. SPT is the most common initial test. It's a skin test. Panels containing potential allergens are placed on her back, each one scratching the skin just a little (It has improved considerably; when my dh was tested 30 years ago, they used little needles to prick the skin). My dd, our oldest, had some testing done in September (she's 9) and she said it kind of tickled, didn't really hurt at all. The allergist then measures the weals on the skin, comparing reactions to a histamine control.

Please keep in mind that all traditional allergy tests can only measure IgE responses. Your daughter's reactions appear to be gastro related; gastro reactions are frequently caused by non-IgE-mediated allergies and won't show up on a test. If your allergist is any good, he/she will acknowledge that the tests are limited and that "reaction trumps test". Too many allergists and other medical professionals will write off non-IgE-mediated allegies as well as other false negatives as "sensitivities" or the result of a mother's over-active imagination. If you get discouraged by the test results or by the dr's lack of concern, just remember that the top allergists in the country would take your dd's symptoms as being an indication that something is going on and would tell you to trust your instincts. If you see an improvement when you remove certain foods, trust that.

A good allergist will also give you a list of foods and ingredients to avoid, as well as substitutes for those foods when applicable. If a test result is high, you should also leave with a script for an epi-pen, jr. Reactions can change abruptly and you'll need to be ready. A daily antihistamine is not needed unless you see a constant problem like scratching or wheezing or congestion--and then, those might disappear when you eliminate allergens. We have no need for an antihistamine unless ds2's having a reaction.

HTH!
Missy

[~*max*~]

An excellent book to read about food allergies is, "Is This Your Child?" by Doris Rapp. It helped me tremendously. Also, come join us in the "Mamas of food allergic children" tribe. There is a lot of good information & support there.

Good luck at the allergist.

[leavesarebrown]

We had an okay but not great experience with our then 18 month old and an allergist, as well as a VERY TRAUMATIC experience with the same child once he was 3 years old (different allergist), who disregarded our concerns when I said I did not want the skin testing done again since it had already been done. And they used the old (razor points) test... I regretted it exceedingly. Especially for food allergies, the skin test is very inaccurate. Blood tests are more accurate for food allergies (that was also traumatic). Challenge tests are done on follow up anyway. It is possible to start there (with the challenge test), though, depending on the doctor, those might not be taken seriously unless you keep really good records. I was important for us to find out that he was for sure allergic to cats before we removed them from our home since that's such a sad thing in and of itself (he has asthma). But hmm.... at LEAST I should have stuck to my promise to him that there would be no pokes that time (he still remembered the previous bad experience) and rescheduled to a day when I could have better prepared him. Also find out if they are doing the old or new test. Some allergists do not feel the new "scratch" tests are accurate at all.

[Missy]

Some allergists do not feel the new "scratch" tests are accurate at all.

I think a lot depends on the allergist and how he interprets the test and perhaps even how it is administered. At 6 months, Sterling's tests corresponded perfectly with his reactions as well as with the subsequent RAST (blood test) at 22 months. The only false negative was wheat. I have heard many people, including peds, assert that allergy testing isn't accurate on young babies, but that just wasn't our experience. And thank gd the tests were accurate--we had a very sick baby and really needed some answers. I will also say that Dr. Wood, of Johns Hopkins, is one of the country's leading allergists and he uses the SPT for initial dx. It is not recommended for a child with a history of ana. reactions because it is a direct exposure to the allergen. Additionally, in the sequence to confirm that a child has outgrown an allergen, the SPT is often used following a negative RAST because it is a more sensitive test.

Missy

[LaLa]

if your child has a gluten sensitivity it could very easily be missed by an allergist through traditional medical testing.

It sounds like you are already aware of some main irritants. I would recommend avoiding those foods until your little one is feeling good and then trying to reintroduce them at that time (assuming they do not show up as allergens.)

We had so many confused and conflicting results from the many tests we did wtih Bean that I found the overall experience to have only added to the confusion.

I hope you have better luck