Peanut reaction...do I need to take DD to docs?

[TettyLouBar]

Hi there,
DH gave DD a really thin smearing of peanut butter on toast this morning and 10 mins after eating shes developed a rash around mouth and neck and she's scratching like mad.
No breathing difficulties. no crying just irritated by it.

What do I need to do now? she obviously has had a reaction to peanuts but I dont know what the next step is

[cheerfulapple]

Hi
I have similar and I would take her to the docs. I know that some oral allergies are separate to the ones that cause the throat to swell up but it is definitely worth a trip to the doctors.
Hope it was a one off though!

[Bilbomum]

Yes, take her to the dr and insist on referral for allergy testing. Presumably it's the first time she's had peanut? Severity of reactions can escalate so you need to make sure you have proper advice (although GP's aren't always that great tbh). You could try a tiny amount on her skin (on arm not face) and if she's allergic it should come up in a rash, take a picture to show the doctor.

The current advice is to avoid all nuts because of risk of cross contamination from peanuts. In the meantime give her some Piriton if it doesn't settle down. Make sure you have Piriton with you until you get the allergy testing sorted just in case.

Don't panic by the way, nut allergies aren't the end of the world. I remember when ds was diagnosed (he has multiple allergies) I was devastated but you get used to dealing with it very quickly and it becomes part of life. This board is a great help so keep in touch .

[Golda]

Try and get your GP to refer you to a peadiatric allergist rather than a general peadiatrician. They are like hens teeth so it may not be easy depending on where you live. Ask to be tested for peanuts and treenuts as almost half of people with peanut allergy are allergic to one or more treenuts.

Peanut allergy is easier to deal with than treenut allergy and more likely to be outgrown.

Ds's allergist has advised that it would be unsafe to pick out (for example) cashews from a bag of mixed nuts but it would be ok to eat cashews from a bag of just cashews (he is only allergic to peanuts). He also says that reactions getting worse with repeated exposure is an old wives tale and the severity of the reaction is related to the amount ingested, which as it is accidental, is different every time. He anticipates that desensitisation will be used as a treatment in about 3 years. If you are interested in desensitisation you could read BlueBummedFly's threads about her DSD.

You can buy small bottles from pharmacies so you can carry a dose of piriton in your bag.

It might be a good idea to carry something in your bag that your dd can eat if you are in a situation when food is being handed out to other dcs and you don't know what is in it. Some companys have good websites telling you about allergens in their products (cadburys and united biscuits are good iirc)

[MmeGoblindt]

I asked about this on the web chat thread with the allergy specialist recently, and was told that we should have her tested as the first reaction might be mild but subsequent reactions could be worse.

How old is your DD?

Just noticed that Golda's allergist says that reactions getting worse is an old wives tale. Hmm.

Definitely speak to your GP and if you can get an appointment with an allergist.

[Bilbomum]

Interesting comment from your allergist Golda, I've never heard that before. DS's reactions to milk were at first fairly mild but then escalated alarmingly on a tiny accidental exposure. His RAST test also showed a massive increase in his allergy levels as well so it wasn't to do with amount ingested.

I also asked our specialist on Monday if it was worth testing ds to see which nuts he's allergic to (he tested positive to nut mix) and was told it wasn't worth it as the advice would still be avoid all nuts.

If only the specialists could agree with each other - it would make life easier for all of us...

[TettyLouBar]

Thanks for all of you feedback. I didnt wait very long after I posted the question before I rang Doc's and he had her in straight away.
It was a mild-moderate reaction. Swollen lips and cheeks, hives on her forehead and chest and nappy line. It subsided completely after 2 hours.

Shes been prescribed piriton and Ive got it with me in the change bag. We're avoiding all nuts and he's made a referral for allergies testing at the hospital but I didn't know to ask whether it was a paed or a allergist Dr.

She's sleeping off the piriton now. I think she's had peanut butter only once before and I must admit Ive always been a little paranoid of this happening (can't really say why but I was expecting it!?) despite Myself, DH and all members of our family not having food allergies.

The first time she had some of my toast with peanut butter in a few months ago I thought I noticed redness around her mouth but I thought at the time I was imagining it as I was thinking about allergies as she was eating it!

DD's 15.5 MO by the way.

So anyway, we'll wait and see what comes of the allergies test. really glad mumsnet was here to ask you guys, its so reassuring

p.s. so each exposure doesn't worsen the severity of reaction then? I always thought it did? its been the case with me and penicillin anyway

[BlueBumedFly]

Tetty - hello!

I am of the school who believes the second exposure is worse than the first. That is what I have always been told by specialists anyway.

As Golda said we have had SDD desensitized to peanuts very successfully and she was anaphylactic. We are approaching the washout month soon so we are all on tenderhooks to see how her IgE responds.

I am having DD (2.5) tested in a few weeks to see if there is any link, any link to DH's psoriasis and if she has carried over any more intolerances that she had as a baby like dairy and wheat.

Good luck, hopefully she only has a mild allergy or intolerance and she may grow out of it, if she it will happen by around 4 years old.

[bruffin]

We were told the same Golda about reactions getting worse and our experience has also born out that peanut is more likely to be grown out of

DS's allergies appeared when he was 4 when he had reactions to seseme seeds and pecan nuts in one weekend. He had been eating peanut butter for years before that but after that weekend he couldn't.
He was tested and was allergic to most treenuts, seseme and peanuts.

I had him retested at 12 and he is still allergeic to most treenuts except cashew but is now clear for peanuts. Still allergic to seseme and also to cats and pollen.
He is now 14 and can eat peanuts and cashews with no problems at all.

[MmeGoblindt]

Interesting.

DD seems to have desensitised herself. We did not have her tested as our paediatrician at the time advised against it. She wa about 2yo when we first noticed that she got a skin rash when eating nuts, particularly haselnuts (nutella). She admitted at age 6yo that she has been sneakily eating nuts from the trees in kindergarten for ages. This was when we moved house and rhe new school wanted her tested before she could have school dinners.

Maybe she had just grown out if the allergy.

Glad that your GP took it seriously and arranged for some follow up tests, that is reassuring.

[Golda]

BBF, was it Andy Clark who told you that subsequent exposures are worse? He is the one who told us they weren't. I wish they would make up their minds.

[PickleByName]

When DS was referred for allergy testing at the local hospital (he has a peanut allergy) we were told that about 80% of time any following reactions are the same as the first, in 10% of cases they are less and in 10% they are worse.

HTH

[tatt]

well our paediatric allergy consultant told us reactions were unpredictable and could be totally different next time. For us he was right - we've had an extremely bad reaction reaction, needing to use the epipen, to food supposedly nut free. I know of several people who have reacted to traces, even to airborne traces. So it certainly isn't the case that anaphylactic reactions are only to large amounts of nut - I wish it were true but it's not.

In general reactions to large amounts of nut will be worse than to small amounts of nut and in general if you've had minor reactions before you're likely to have minor reactions again. But it's not something to bet a life on and my child, for one, would have been dead now if we had assumed that traces always caused minor reactions.

OP you'll probably be seeing a paediatrician. They can do allergy testing as well as a consultant allergist so the test results will be fine. They aren't all as good when it comes to advice if the tests are positive. But if your child keeps the allergy then you'll learn to manage it.

In the unlikely event that your child develops allergy symptoms before you see the consultant do not spend time saying they haven't had any nut - dose with piriton first and worry about whether it was necessary later. Any facial swelling and get medical help promptly.

[BlueBumedFly]

Golda, you know I cannot remember ever speaking to Andy Clark about it, I assume I didn't, I think we were too focussed at that time of the progress rather than cause and effect.

Over the years we had many opinions, the only one I have ever trusted is Dr Clark. I wish we were going to him for DDs nut testing but I have to start in area with her so fingers crossed on that one. I am not lying when I say I am pretty petrified, she seems to react to quite a lot as far as mouth rashes are concerned, not a good prognosis

[TettyLouBar]

Wow, you ladies are extemely knowledgeable in this area. I'll be coming back here in the future when DD's been tested!!

All fine over the weekend but I'll be popping out to get an extra bottle of Piriton tomorrow to keep in her change bag. Shes at nursery on mondays and wednesday mornings - what can I do with regards to Piriton administration if something happened there? any experiences? I'll have a word with the senior woman tomorrow and discuss it.

[girlsyearapart]

I think some reactions worsen over time.

Dds allergies seem to be subsiding but still reacts to a lot. And has never had nuts.

My own wasp sting allergy was worse the 2nd time I was stung.

If I were you Tetty I'd explain to nursery what you posted on here about the reaction.

Send in a labelled bottle of Piriton and always let them know when she last had some.

ps- bbf how's the poo situation??

[BlueBumedFly]

Hello girlsayear - dreadful!!!! Not getting any better, still holding back and not managing to ask for the potty or loo. Have backed off, will start again this week. How about you?? X

[wicked]

You should definitely take her to the doctor. The first exposure is usually mild, but the second exposure can be really severe (life threatening).

It sounds like your DD is the candidate for an epipen..

[girlsyearapart]

Sorry to say bbf it appears we've cracked it.. [smug/relieved emotcion] [feeling your pain emotcion]

[bellabeauts]

Hi
Some great advice on here! Thanks everyone! My DD (2.6) has recently been diagnosed with peanut and egg allergies and has just started pre-school. I am still trying to get my head around it but we are receiving a lot of support from our hospital after an initial cock up with getting her diagnosed (have since moved GP). She underwent the skin prick test at St Thomas' and they were brilliant and I feel much more informed though at times feel very anxious and worry about the future. Good to hear she may grow out of it...

With regards to pre-school/nursery Tetty the staff at ours received Epi-Pen training from the nurses in our area as another child has similar allergies and I leave a named bottle of piriton and epi-pen there. I was however a bit concerned that another child with intolerances (not allergies) got hold of a cake that may have had traces in! Luckily my DD is very aware of what to avoid and wouldn't dream of taking something but the very fact this child was able frightens me a bit! Anyway if your DD is diagnosed then I would ask the nursery if they are trained in epi-pen admin and if not get them to arrange it for peace of mind for everyone.

I will definitely be back here for advice as many of you seem very clued up! Thanks again and good luck Tetty!

[TettyLouBar]

Thanks everyone. No more dramas yet so just awaiting the referral to come through

[madrehayunasola]

BBF, how is your daughter doing? I was following her des. treatment a few months ago (when she managed to have her 30 peanuts!), and haven't been to Mumsnet for a while... also, do you know what happens next? Will she have to have a bit of peanut daily/weekly?