food allergies advice

[shevacc]

DH and I are trying to figure out next steps after G's reaction to peanut butter yesterday. Our pedi recommended assuming she has a severe peanut allergy and acting accordingly -- no peanuts in the house, read labels, alert all caregivers. I will ask Monday about an epi pen. However, he would rather wait to do the actual allergy testing for another ~year since it involves a blood draw that can be traumatic for LOs. He's open to doing the testing sooner at our request.

biblionerd, jaime183, Dr. rjamz, or anyone w experience, would allergy testing tell us anything we don't already know (ie she reacts to peanuts)? Should we insist on seeing an allergist? What could they do for her besides confirm the allergy and have her avoid peanuts?

We will tell her daycare Monday. It's already peanut free, luckily. We'll also ask her pedi about an epi pen and get rid of our peanut products. Should I be doing anything else?

@thadsrad and rxbeth, be careful. We had given peanut butter once before and noticed her face was a little red, but chalked it up to strawberries. 20/20 hindsight...oh well.

[Deleted]

We did blood testing with Laney- it wasn't too bad. They had a hard time getting a vein but she was fine 5 min later.

Her blood test was negative but we still aren't sure (she doesn't have strong reactions but we think she's allergic to dairy and maybe fish)

We are going to an allergist this week- probably for skin testing.

In my case- I'd prefer to know for sure either way. First of all, it's really hard/inconvenient to avoid dairy. Second, I'd like to know if she's allergic to anything else. Also, in our case, if she's not allergic to dairy then I want to know what's causing her issues (mostly poo issues)

To me it doesn't seem so traumatic that it's not worth it- I mean I had spinal meningitis and a spinal tap when I was 4/5 and I don't remember any of it...

[thedahliharpa]

Both girls had blood draws as babies. H first at 9 weeks and D at 7mos. We did skin testing with H at 13mos.
They test for a slew of things during skin testing. If I was in your shoes I would want to know ASAP if other nuts might pose a threat.
Our pedi is great but we learned so much more at the allergist.

[thedahliharpa]

Also peanut allergies are one of the things they are having some successes treating with VERY controlled exposures. I would want to learn if that would be an option in the future and try to work with someone who is current in those studies.

[biblionerd]

I would most definitely want to see an allergist asap. I think it's honestly really weird for a pedi to recommend to wait a year for a blood draw because it can be traumatic. Fiona barely flinched and maybe cried for 10 seconds. Not traumatizing AT ALL!! An allergist is just plain more knowledgeable about allergies than a pediatrician. It sounds like your pedi is taking it seriously if they are recommending strict avoidance, but the fact that they didn't recommend going to the ER or at the very least coming in Monday for an epi pen just concerns me. Our allergist does blood tests to follow up with allergy reactions to gauge the severity. Fiona reacted fairly strongly to peanuts with the skin prick test, but tested low with her blood. He said to keep strict avoidance for now it is a really good sign that she will outgrow it. He said that when there's a known or suspected allergen they always run a standard set of allergy tests to test for all of the main allergens. It's really reassuring to know that although she's not allergic to peanuts that she can have tree nuts. I PROMISE you I'm not knocking your pediatrician, but the fact that she has an obvious peanut allergy and YOU are the one having to bring up the epi pens means to me that she would be receiving more comprehensive care at an allergist.

[ashleydl83]

I agree with biblionerd. She needs to see an allergist. An allergist is going to give you way more info and advice. My brother has food, environmental, and drug allergies and they were able to determine them by the skin test. It was a stressful time for my parents, but they got so many answers. Good luck!

[thedahliharpa]

Oh yes, biblionerd is correct. The skin tests will gauge the reaction level and then over the years you can compare retests to know if it is getting worse or better. This would indicate if a challenge ever becomes a safe course of action to explore. It will be good to get a baseline analysis at the onset of the allergy for future reference.

[jaime183]

Our ped did the blood test which helped the allergist but he did the skin test. The blood draw was more traumatic than the skin test.
We were told to avoid nuts and seeds because of a borderline peanut score and in a few months we will do a tree nut panel
Definitely go to the allergist that's what they are there for

[jaime183]

And yes at the minimum you need it for a baseline to see if she's growing out of it

My dr is big on the food challenges so we liked him

[The Foozzler]

Jun 2, 2013 0:25:12 GMT -5 thedahliharpa said:

Oh yes, biblionerd is correct. The skin tests will gauge the reaction level and then over the years you can compare retests to know if it is getting worse or better. This would indicate if a challenge ever becomes a safe course of action to explore. It will be good to get a baseline analysis at the onset of the allergy for future reference.

As someone with some food allergies, this is what I would recommend. An allergist will track the skin test results over time. It is possible to outgrow an allergy and the skin tests are really good at giving that information. I've gotten it done many times over the years. My mom told I was fine during it.

Also, I've had reactions that have been both just skin irritations and anaphylaxis. I've only had anaphylaxis once, but I never know which it will be, so I go to the ER every single time I suspect I ate something I shouldn't. Every time.

[rxbeth]

Thanks, shevacc.  Sorry, I haven't been logged on much this weekend.

We are seeing our pedi again on Thursday about her ear infections and I'm wondering if I should bring this up again.

Like I said, she had red splotches around her mouth (but not raised) both times I did peanut butter.  His advice was no PB until she is 2 but he didn't think she needed an epipen.  Does that sound right to anyone?  Her daycare is peanut free.  I was thinking of telling him that they insist on having one but I'm not sure.

I'm also not sure if we need to be avoiding all nuts.  He didn't recommend an allergist at all.  Although, it would likely take 6 months to get into an allergist here.

[ruby412]

Shevacc, I'm sorry you have to deal with this! I can only imagine how stressful being an allergy mama is. I would opt to have the testing done so you know for sure about peanuts and other possible offenders. Violet has had blood draws many times and, while they suck, kids are very resilient and move on quickly. It's definitely harder on mom and dad!

[creamsiclechica]

I have to second (third?) biblio's suggestion. My nephew has a very severe peanut allergy, and until he went to the allergist, they weren't sure of the level, and I think that's incredibly important to know. I'd also address the epi-pen situation as soon as possible too. Just because if it's anaphylaxis inducing, I would one hundred percent want that in my possession. We don't know if A has an allergy, but just because of my nephew's history, we are strict avoiders too in case, and it can be hard. But the allergy panel told my sister he had not just peanuts, but tree nuts and sunflower oil allergies to deal with, which she'd have never realized otherwise. In my opinion, you just can't be too careful, and reading G's reaction and just how scary it was, I'd rather risk the blood draw than another reaction. So many hugs too, by the way, I haven't had a chance to respond to much this weekend, but I was just so scared for you reading your post. I hope you can get some answers as soon as possible. Lots of love!!

[Deleted]

Thanks for the heads up, shevacc. I was so sad and scared for you guys! Per our pedi we are avoiding peanuts till 2 but aren't doing anything else until then. Our pedi stressed watching him closely around allergenic foods and that any other reactions would change her approach.

I would want the blood testing done because I would want to start making appropriate changes in our diet immediately.

[biblionerd]

Jun 2, 2013 21:34:01 GMT -5 rxbeth said:

Thanks, shevacc.  Sorry, I haven't been logged on much this weekend.

We are seeing our pedi again on Thursday about her ear infections and I'm wondering if I should bring this up again.

Like I said, she had red splotches around her mouth (but not raised) both times I did peanut butter.  His advice was no PB until she is 2 but he didn't think she needed an epipen.  Does that sound right to anyone?  Her daycare is peanut free.  I was thinking of telling him that they insist on having one but I'm not sure.

I'm also not sure if we need to be avoiding all nuts.  He didn't recommend an allergist at all.  Although, it would likely take 6 months to get into an allergist here.

I would not feel comfortable without an epi pen if my LO had ANY reaction to peanuts. Reactions can worsen with exposure and change. I feel like a broken record (sorry), but even with "just" a skin reaction my pedi wouldn't let us leave without an epi pen. He said often it takes numerous exposures to get the full effect. 

[jaime183]

The skin test is more accurate than the blood test so if you had to pick, I would think that would be better. The allergist used our blood test because we had them but he wanted his own skin test done to confirm- and once we did that we were allowed to reintroduce wheat

[spaghetticat]

I agree with everyone else and I think an allergist/skin test would be the best course of action.

I don't like your pedi's mindset at all. Avoid getting more information bc it's an unpleasant experience? Gimme a break. V had the blood draw and it did kinda suck for about 5 minutes. And that was it.

Good luck. Please keep us posted!

[fryjack2]

OMG. This is my 3rd attempt at replying. I'm not going to try to quote you anymore.

Your doctor is being ridiculous. A traumatic lab draw is WAY better than what could have happened. Insist on having a blood test (and a skin test if you want) and absolutely get a script for an epi pen. Make sure you know how to use it before you leave the office. Its not hard, but you are going to want to make sure you aren't using the wrong end.

Based on what you wrote about EMS taking 15 minutes to get there, the fact that they didnt take her in, and she vomited (a sign that her reaction wasn't over) an epi pen is necessary. I've sent many a peanut allergy to the ER for 24 hour observation after a reaction. Also, if you give her benadryl again and she pukes it up within 15 minutes, you can redose her. Just double check with your pedi instead of saying you heard it from some internet stranger

There is no harm in seeing an allergist. They will know more than your pedi. Henry has an egg allergy. We are taking him to an allergist to have more testing. Its just a good heads up for future issues.

Allergies are so scary! Good Luck!