Introducing nuts when you don't know if a child is allergic or not - where did you do this?

[Tinkjon]

I feel a but daft asking this, not sure if I'm being ridiculously over-cautious - please don't laugh at me

DS is coming up to 5 and she's had no nuts until now (family history of allergies/asthma etc. though no nut allergy in immediate family). I want to try her with peanut butter soon but am scared of doing it at home in case she has anaphylaxis. That's obviously the worst case scenario but if it happens then something awful could happen before there was time to get her to hospital. I've heard somebody say that they sat in the Casualty department of their hospital when giving their child nuts for the first time, should I do that?! Is that really dramatic? What did other people do?

Try a very small amount, in the morning or at lunch. Remember that a reaction can occur the second time you give something. Also peanuts aren't nuts!

And don't worry too much about doing it at home. Worst case scenario as soon as you notice any swelling call an ambulance - but I'm sure that won't happen!!

director of childrens A&E where we are told my DH to give DD peanut butter in A&E as our DS has a peanut allergy ... and we found out the hard way with him!!

you don;t really have a reason to think she is going to have anyphylaxis, but then i had no reason to think DS would be allergic either

You can never prepare for everything - ds had anaphalaxis to chickpeas - v unusual.

did it at home with piriton handy because I didn't know any better. However when she proved to have a nut allergy the consultant wasn't too impressed by that.

Smear a little on skin first - arm or back. Then smear a little on the face. Then a little on the lip. Leave enough time (minutes not hours) inbetween to see if there is any sign of redness or swelling. If no apparent problem they can eat a little. Good luck.

Thanks, everyone. Tatt, when you say your consultant wasn't impressed, what did s/he say you should've done - the 'smearing first' thing that you suggested to me?

He described how they would do it in hospital for a food challenge - progression from arm or back to face, lip then swallow. The "smear a bit" description is as close as you can get at home.

Tatt - do you happen to know if it is possible to get "proper" food challenges on the NHS for a child with a family history.

We have a similar issue to the OP (so not totally hijacking!) DH is severely allergic to nuts - nearly died in his teens. DD1 is now five.

We have a nut-free home and there is no earthly chance that we are going to bring nuts into it to experiment on her. So I'm not sure where to go from here. I know that we can request blood tests, but I don't think they are going to tell us much, since she has never consumed any nuts to produce any antibodies. And I would like to know whether we need to carry on being neurotic about her diet when she is out at friends houses etc.

I will get around to asking my gp these questions, but I suspect that there is more expertise on this forum ...

smithagain it does no harm to ask but I wouldn't be very optimistic about your chances. Depends a bit on where you live but I've heard too many stories of people who have trouble getting a referral even after a reaction to nut. Also you don't inherit food allergy, only the tendency to be allergic (or so they say).

If the gp says no ask for a blood test. It used to cost them 8 pounds, may be a bit more now. Normally by the age of 3 a British child will have been exposed to peanut (according to a good allergy clinic when I asked about getting my other child tested). Traces of peanut get everywhere, especially ice-cream and chocolate. In a household avoiding "may contain" products that might not happen but she may still have been exposed outside your home. The overall IgE level will tell you if she's likely to be atopic even if you don't feel too confident about the nut result.

If your dh has an epipen you could take that to a friends house for peanut butter smearing. If he doesn't have one get him a referral to ask for one and maybe the consultant will take pity on you and do a skin prick test on your child / will speak to your gp and arrange a referral.

Thanks Tatt - that is more or less what I suspected.

We do have Epipens, for both DH and DD1 (she does have a bee sting allergy, which I forgot to mention). Having seen DH react, I'm decidedly jumpy about doing a DIY food challenge - although I like your HV's style, Starlight!

I will now get organised and go to the gp to see what I can get out of them.

Sorry about the hijack Tinkjon. Let us know if/when you decide what to do!

Smithagain, no worries about the hijack - it's just what I was wondering myself! I'm going to do what Tatt suggested, smear a little bit, then give to eat. Re. doing this in a GP's surgery, I actually had an appointment yesterday and on the way there (when it was too late) I thought I should've brought some nuts with me and tried her then! I have a friend who lives pretty much next door to the hospital, so I think I'll wait until we're at her house one day and do it then. Thanks for advice everyone!

smithagain your child already having one allergy ought to increase the chance of a referral so don't forget to tell the gp. Allergy clinics always ask about any previous reaction. Most gps are just so ill informed you can't tell how they will react.

Thanks Tatt - I think I know where we are headed now. Just trying to second guess which of the many gps at our practise might have some clue.