DD1 has peanut allergy - very confused can anyone help?

[Lovestosing]

I'll try to keep this brief; basically DD1 (4) was diagnosed with a peanut allergy when she was 13 months. She has never had an epipen or equivalent just antihistamines. We were told that as we controlled her diet that she shouldn't need one but this would be reviewed before she started school. I must add that she only ingested some peanut once, she got hives all over but was fine otherwise, but when she had the first skin prick test her reaction was described as "quite severe". She has been tested once a year since then and the last two years her reaction was less severe so the consultant said last year that if her reaction had decreased or Stayed the same this year they would do a food challenge before she started school. I have taken her today and her reaction is worse than the previous two years though not as bad as the first year she was tested. Her new consultant (old one now retired) says her reaction is too severe to risk doing a food challenge. Fair enough, but what I don't understand is why we haven't been given an epipen? I did ask the question but couldn't get a straight answer. Is anyone able to explain the general policy on epipens? Are they only prescribed to people who have suffered anaphylaxis? I suppose what I'm struggling to comprehend is why is it too dangerous to do a food challenge under controlled conditions but it's fine for her not to have an epipen? I'm afraid we really have been given no information since she was diagnosed with the allergy and I'm really rather worried now.

Given what the consultant has said I really do think you should have epi-pens for your daughter. You either need to go back to the consultant and basically demand that they prescribe them or ask for a second opinion (which you're entitled to). I would also have a look at the NICE guidelines on allergies and anaphylaxis and get in touch with the Anaphylaxis Campaign - they are brilliant and will be able to offer you good advice. The policy around prescribing epi-pens varies from doctor to doctor and some will only prescribe after an anaphylactic reaction but others will prescribe as a precautionary measure to make sure that they are available if the child does have an anaphylactic reaction. My experience of the NHS is that you have to fight for what you think is best for your child.

DS had nut allergy since he was 4 and wasnt given an epipen because his breathing wasn't affected and he doesn't have asthma. He did get an epipen when he was 16 because he ate a biscuit with macademia nuts which then affected his breathing, but saying that he got over that episode with just piriton.

DS has has other allergies, milk, egg and fish, since birth - had bad reactions vomiting, hives, wheezing, but no airway problems and never had epipen.
Unfortunately he has recently reacted to nut (age 4), the reaction involved airway restriction (he couldn't speak, I called ambulance as worried about breathing). It actually went down with piriton but due to this incident and 'new' allergy, we now have epipens. Also our action plan was changed from an 'allergy action plan' to an 'anaphylaxis action plan'.

It is really difficult in your situation. Epipens are a drag and a responsibility and you really don't want them if you don't need them, but I can see why you are concerned as you don't know what reaction wuold be.

Also nut allergies as far as I know tend to be more severe and more likely to stay with the child for longer / for life.

Can't really advise but second others' advice to go back and explain your concerns, read up on anaphylaxis etc.

GOod news is schools seem to be very aware of nut allergy and kitchens etc probably nut free.

Another little thought - were they to do food challenge, they probably wouldn't get as far as inducing anaphylaxis as would stop at first hive and advice would be to continue to avoid (have had this with milk / egg).
So not sure food challenge would help you - it is more used where there is a chance the child can tolerate the food than to see how bad reaction would be.
I think you need to ask all the questions at the end of your post to the consultant or a different one if you're not happy with yours.

Check out the Anaphylaxis Campaign support groups at www.anaphylaxis.org.uk/events?cat=2 - some have allergy consultants attending and might be an option for some informal advice.

My dd has a peanut allergy and was given an epipen as a matter of course. She was seen at Addenbrookes which is a leading light in terms of allergy treatment. I would go back and ask for one. Actually, ask for two.

Hi, you should definitely get a couple of Epi-pens and fight for them if necessary. My 4 year old has a peanut and shellfish allergy and whilst she hasn't had a reaction involving her airways (yet, thank goodness) I feel better knowing I have an Epi-pen to hand should the need arise.

Don't be afraid of having an Epi-pen, they are really easy to use and can't really 'harm' a child if they are used perhaps when they are not totally necessary.

I think a lot of GPs are relucant to prescribe them if a child doesn't suffer from Asthma or the reaction has been mild, but equally lots of GPs do. For your own peace of mind I would insist on two of them. I've heard a lot of it boils down to cost but not sure how true that is.

Good luck!

DS has asthma as well as anaphylactic allergies to egg white and nuts. If your daughter's breathing becomes affected then she really should have an epipen. I would say she definitely needs one when she starts school, you never know what other kids may bring to school, like snickers bars etc, and offer her some. If you are worried enough, then tell your GP she needs one. Actually, get 2. And get them on prescription, as the shelf life is extremely short. We just got a new one, and it's shelf life expires in December. Good luck.

Thank you for all your replies, have been advised to go to GP anyway for DD2 who has asthma and has never been exposed to nuts so will need GP to refer her to Allergy Clinic. As ridiculous as it sounds I'd rather know what would happen if DD1 ingested some peanut or at least know that if she did and her breathing was infected that we had something to give her immediately.

Sorry but another question about epipens; as DD1 is under a consultant would a GP prescribe an Epipen as her consultant hasn't?

Anyone?

Ds was given his epipen by gp at 16 when he had the reaction that affected his breathing.

I think the GP would usually go with the consultant's view. For us it was prescribed by hosp consultant, but GP will do repeats. Having said that, your GP might be a good first port of call to discuss your concerns and might even talk to the hosp consultant for you.

Btw have just been through similar with DS2, got him tested for his brother's allergens and all the nuts, as he had eczema and coudln't be sure if he was clear of allergy. He came out completeyl clear - not a single hive on his little arms even though they used all the space on both for the skin pricks. Very odd for me to see as DS1 would be writhing with the itching after any such text! Hope your lo is clear too
x

My dd has not had breathing probs but lip tingling and itching for peanuts. We have 4 pens, 2 at school and 2 at home. The consultant was very willing tonprescribe them but it was my choice. I felt better having them as back up but hope I never need to use them
We did go private though as my dh has health care with his job.
We get the repeats through the GP.

Keep on fir your peace of mind.

each exposure to an allergen doenst always mean full blown anaphylaxis, but a deffo reaction happening. however the risk of severe rxn is there.

sometimes saying a peanut allergy is mild is a bit like saying you are only a little bit pregnant. either you are pregnant or your not. iyswim.

our son is not asthmatic, and had a long list of allergies, but first to egg and peanut. he had epi pens a 2yrs. allergy list was still increasing then with many mild reactions. between 12 and 15 we have used the epi pens 3x.

if you are lucky and by 7 your child outgrows than your kid is within that rare 20%, otherwise, this is a life long allergy with the potenital to be life threatening.

My previous posts were removed as I inadvertently broke the house rules - but what I was saying was that I agree with other posters;

My daughter had what was described as a "mild" reaction to peanuts, although she still spent six hours in hospital. It took six months and seeing four different doctors to finally get her an EpiPen - the specialist who did prescribe it was shocked that the others hadn't as he said a mild reaction now can always develop in to a severe or life threatening one next time.

In short, I would say, always push for an EpiPen, no matter how mild a reaction they initially have to peanuts. You don't what to let it rule your life, but better to be safe than sorry.

Can you also get in touch with your local allergy specialist in school nurses team and get a care plan done - this is essential from the schools pov so that they know what to do and staff are suitably trained. In my area it's standard and the Sam Linton case certainly made schools take a good look at how asthma and allergies are handled. I've spent this week making sure all dc in my school who have allergies have care plan/ antihistamine/ epipen and we've checked inhalers etc and central recording systems are up to date. most schools are getting good afaik but imho a care plan is a necessity with a known allergy. To find out who it is, start with getting the contact info for the school nurse and speak to them asap