what our allergy dr said

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this past week we has out son retested for his food allergies, nothing has changed. but she said something that made me worried. she said that before he starts kindergarden in 2 years they will do a test where he eats some peanut butter and they watch the reaction! now i know this dr isnt a quack she is the best in our aera, but this makes me realy worried!!! i dont think i want them to do this to my baby! ive seen what happens to john when he eats peanut butter and its not pretty. has anyone else heard of this or is my dr. out of her mind!??!!!???

On Mar 7, 2006

Personally, I wouldn't allow it. Every exposure can cause the next reaction to be worse. I'd definitely ask the dr. why she wants to do this?!

On Mar 7, 2006

How high is your child's IgE? From Dr. Sampson's paper, he said that kids with IgE < 5 and age > 4 years should under go food challenge test to see if he or she outgrows it. Maybe your doctor is thinking along the same line? It'll be logical to repeat the RAST before the procedure though. If it's > 15, there's 95% chance of reating to peanuts and most doctors will forego the food challenge.

Sirimon

On Mar 7, 2006

I think what I usually read is that food challenges like that are done only if the other tests fall to zero allergy detected.

Is that the case for you...are the other tests showing no allergy any more? (RAST, skin prick)

I would never allow this either. No way. Even in a controlled setting don't some kids collapse and die - isn't that why they halted those recent drug trials for peanut allergy...?

On Mar 7, 2006

My DD (3-1/2 years old) recently went through a food challenge for eggs (and passed!) but it wasn't done at whim.

In 2004 she presented with a negative rast test so the allergist followed up with a skin prick test. She still showed some sensitivity so she said "see you next year!".

In 2005 she had another negative rast test and this time her skin prick test also came up negative. After this, the allergist gave me the option to have the food challenge but it was my decision, not a requirement. I went ahead with it mainly because my DD had come this far with testing, I thought I owed it to her to be strong enough to follow through. She had her first cupcake in 2005 and her first brownie in 2006. It was worth all the lost sleep because the sheer joy on her face could not be denied. She was in heaven!

My DD is also PA and TNA but I don't think I would be so agreeable to do a food challenge with peanut and DEFINITELY not if she still showed a sensitivity to those foods in her tests. Just my two cents.

On Mar 7, 2006

What is your doctor's basis for doing the food challenge? My son had an almost negative RAST and had only one reaction to PB which was 3.5 years prior to the rast test. My allergist said that if the skin test was also low or negative, we would do a challenge. The results were completely opposite RAST was low and skin was a 16mm wheal. So, we didn't do the challenge. I would find out why the dr wants to do the challenge and after RAST & skin tests show negative, then do the challenge. Good Luck.

On Mar 7, 2006

I would absolutely not let my child eat pb, unless a negative Rast and a negative skin test were already done. My son had a negative RAST to soy, still tested 2+ on SPT, so even though our PN numbers are very low, our dr would not repeat SPT for PN, we would not allow it had she wanted to, too risky. If you have any history of suspected PN reactions, and any number at all on RAST, I wouldn't let them give my kid PB. DS has asthma as well, so I think that makes me more afraid for him.

On Mar 7, 2006

We had a food challenge done with my non-PA DD this summer because I wanted to have her tested before she started preschool. She had a positive skin test and the allergist said it could be false-positive, so he recommended the food challenge. I've never given DD straight peanut butter but she's had snack bars with peanut butter and nuts in them when PA DS wasn't around and she was fine. I wanted to be sure, so we went ahead with the food challenge, but I can't imagine doing it for DS knowing that he's reacted. I would definitely ask for clarification as to why the allergist suggested this. How frightening for you!

Best Wishes and let us know what the allergist says!

Tracy

On Mar 8, 2006

i have 2 questions, first what is a rast test?? is that the test where they prick the skin? if so he is testing positive for peanut allergy. also i asked the doctor what the diffrent levels of the allergy were and she didnt know what i was talking about! he has an antiflactic(sp) reaction to peanuts , she said if there is an allergy to a food, then they are allergic to foods... i dont think im going to let them do the food challege. its just to scary to me. thanks for all the replys!! erin

On Mar 8, 2006

There are two tests typically done for food allergies. One is a RAST which is a blood test. The other is a scratch or skin test where a tiny bit of the allergen is "scratched" into the skin. there are two tests because neither is 100 percent accurate. Your dr should have negative results on both tests before doing oral challenge. (in my opinion and my dr's opinion.) Before the tests are done, your child must be antihistimine free for several days, maybe a week before the test or it will not be accurate. Just wondering, has your child had a reaction? Any other allergies?

[This message has been edited by saknjmom (edited March 08, 2006).]

On Mar 9, 2006

john has had the skin test and is positive for peanuts, dairy, and strawberries. i believe he is also allergic to blueberries but they didnt have a test for that. the dr. wants to do a food test with pb when he starts kindergarden, in 2 years, she said that is standard procedure... im not going to let them do this. i know what happens to him when he eats peanuts. i dont want to risk his life. erin

On Mar 13, 2006

I completely concur with your decision Erin. I have faith with the medical profession for the most part, but in a pinch I ALWAYS err on the side of supporting a mother's intuition.

That being said, I have never heard anything about peanut food challenges being a standard procedure anywhere and I've done A LOT of research, not too mention a lot of reading here. Can't go wrong with an entire forum of support from BTDT parents I say!

On Mar 13, 2006

thank you all for the info i felt in my gut that a food challenge didnt sound like a good thing for my son. and now i know that im right. i have to remember that just because they are the dr.'s im the mom and if i feel like it just dosnt feel right to trust myself. and my feelings. :.}

On Mar 13, 2006

Tough to follow, but here's my .02:

There are 2 tests.

One is a SPT (Skin Pr!ck test) where they put a big ole lego block on the back and see who gets hives or not on different allergens.

One is a RAST where they draw blood and measure IgE.

Both present false positives/negatives. Nothing is fool proof.

For the SPT to be accurate, you cannot have benadryl et al for 3 days prior...

For a RAST, you're ok with it.

For an oral challenge (like the PB one), I would NOT do it, unless the SPT is negative AND the RAST is negative, and you believe your child is NOT allergic to the food anymore.

Hope that helps.

BTW (By the way) -- No one has mentioned if you have epi-pen jrs or not. Your child had an anaphylactic reaction? You SHOULD and BETTER have them NOW, kwim?

Jason

------------------ [b]* Obsessed * [/b]

On Mar 15, 2006

jason, we did the skin prick test with john, he got 2 fals positives with it, for eggs and corn. but it did confirm our suspissions with his food allergies. our dr never mentioned the rast test. or to wait for the tests to come out negitive. ill have to ask her why.

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