Need advice

Posted on: Wed, 09/03/2003 - 9:28am
pjama0502's picture
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Joined: 08/04/2003 - 09:00

I posted about 6 weeks ago that my 15 month old had a reaction to peanut butter (the reaction was mild). Two weeks ago we took him to the allergist and he had a skin test; the skin test was negative. The allergist then recommended a RAST test. We received the results of the RAST test this morning. The test was positive. At this point we don't know the numbers, but I'm guessing the numbers are low, because the allergist would now like to do an oral challenge in his office! I have read this is a big no no because 1) my son is only 16 months old 2) it's not at hospital. However, I then asked a nurse at an allergy and asthma clinic and she informed this is safe in a clinical setting.

What would you do?

Jen

Posted on: Wed, 09/03/2003 - 10:05am
cynde's picture
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Joined: 12/10/2002 - 09:00

I personally would just treat my child as PA (avoid contact with PN) until he was ready for school, then repeat the skin and RAST tests, if they were both negative then, I would allow a challenge. No-one under 3 needs PN in their diet.
If the doctor thinks the RAST test is inaccurate, why not just do another one?

Posted on: Wed, 09/03/2003 - 10:07am
BS312's picture
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Joined: 09/05/2001 - 09:00

I would get a new allergist. Why in the world would he want to challenge a 16-month-old who might be allergic when no child with a susceptibility to peanut allergy should be exposed to peanut until age three?

Posted on: Wed, 09/03/2003 - 11:08am
Sandra Y's picture
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Joined: 08/22/2000 - 09:00

I agree with cynde and BS312

Posted on: Wed, 09/03/2003 - 11:50am
wendysco's picture
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Joined: 05/03/2003 - 09:00

Ditto the above, be vigilant and treat as PA for now, then challenge between the ages of 3 and 5, and get a different allergist. Get an epi script too.

Posted on: Wed, 09/03/2003 - 12:47pm
momjd's picture
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Joined: 02/24/2002 - 09:00

I wouldn't do a challenge until the child was old enough to clearly communicate what he was feeling. If he reacts without hives this time, the doctor might not recognize it quick enough to take action.

Posted on: Wed, 09/03/2003 - 1:02pm
megans mommy's picture
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Joined: 08/26/2003 - 09:00

Trust your instincts. If you are here asking...you probably are very unsure if this is the right thing for your baby! You are probably right!
I have a 20 month old who is allergic to peanuts (as well as many other things). She was just the opposite. She was negative on the RAST, but positive on the skin-test. I have made an appointment with another allergist. The one who tested her was not at all concerned about the peanut allergy (or the fish either...and I am not so sure Megan didn't have reactions to walnuts and shellfish--from a shared fork--as well). He sort of failed to mention that these are allergies that are usually not outgrown....and can be life-threating!! Did not even mention an epi-pen...Megan still does not have one (I was led to believe she didn't need one and wasn't at risk for that type of reaction)
I decided at 6 months, when I figured out Megan was reacting to peanuts through breastmilk, I would not give her peanuts again....until---I'm not sure when!! She will have to test negative on all tests, and then I am still not sure!! It is just not worth the risk!!
Oh, by the way, Megan also had 'mild' reactions. She threw up and had horrible stomach cramps. But that was only being exposed through breastmilk.....I don't know what type of reaction she would have if she actually ate peanuts!

Posted on: Thu, 09/04/2003 - 1:49am
CorinneM1's picture
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Joined: 06/20/2002 - 09:00

My thoughts exactly. New allergist...or go ahead and make the appointment for the year 2005.

Posted on: Sat, 09/06/2003 - 8:02am
nikky's picture
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Joined: 11/14/2000 - 09:00

I would definately say no to the oral challenge. No child should have peanut before the age of three andway. Besides, you'd only be re-exposing him. Wait and re-test after age 4 with a new blood test.

Posted on: Sat, 09/06/2003 - 8:21am
JAK's picture
JAK
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Joined: 09/06/2003 - 09:00

I personally would wait. At least try a different allergist before going ahead with it. If you have a large Children's hospital with a good immunology department..try there or make sure they specialize in pediatric allergy. I was very unhappy with the first allergist I tried & he was going to do the same thing (oral challenge). I went to another & he said he would not do anything until after age three (we knew she was PA..it was a pretty clear cut exposure/reaction). He did nothing until age 3 then did a skin & blood test. Skin was 4+ and blood was high enough that he said an oral challenge would by "too risky" at that level. We go back at age 5 just to do the skin & blood test. I do like him but my second DD is going to be tested at the Children's Hospital nearby. Doesn't hurt to have a different perspective. I feel educated enough to make my own calls. We avoid PB and always have epi & Benedryl..no reactions since initial. So far, so good. Definitely try another allergist.

Posted on: Sun, 09/07/2003 - 4:22am
ElizabethsMom's picture
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Joined: 04/17/1999 - 09:00

Ask your allergist how many children with PA he has diagnosed and treated. Grill him and find out why he wants to do an oral challenge next....

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