Skin prick test, how to proceed

[Foreignmumof2]

Hi all,

My 15 month old DS has had reactions to multiple foods since we started weaning him (and even prior due to cmpa) so we got referred to an allergy clinic. DS recently had a skin prick test and was diagnosed with several allergies, the paediatrician told us to retest in a year and that he would refer us to a dietitian.

so my question is really How accurate are skin prick tests? I’ll attach a picture of his test results.

I don’t doubt the egg and cows milk allergies since egg allergies run in my family and my oldest is allergic too. With the cows milk allergy he’s had the most reactions, projectile vomiting formula, severe eczema due to me consuming it and hives when I was weaning him and introducing dairy.

The paediatrician didn’t consider DS allergic to lentils or chickpeas even though he had a (small) reaction on the skin prick test and DS threw up whenever he ate these foods.

The other odd thing is that DS has oat porridge (made with water) and can have oat milk in his pancakes but will throw up if I make his porridge with oat milk or give him oat milk to drink. He had no reaction to oatmeal on the skin prick test. Could this just be an intolerance rather than an actual allergy?

DS is exclusively breastfed and the paediatrician urged me to introduce him to oat or almond milk. I’m a bit weary of introducing almond milk since he did have a reaction to almonds in the skin prick test, but then he’s never had it so would it be a good idea to introduce almond milk?

Sorry if this is long, I’m just at my wits end with worry about introducing him to new foods. Thanks so much

Food allergies are the worst OP, you have my sympathies.
DS is 3 and has many allergies (milk, egg, legumes, fish and several others).

Skin pricks are only about 50% accurate and you get false negatives as well as false positives.

As an example, DS had a 6mm result for peanut and a 2mm result for wheat when he was 6 months old, but isn't allergic to either.

Conversely, his kiwi and hazelnut pricks were negative buts he's definitely allergic to both (confirmed in hospital with a food challenge when he was 2).

Dairy and egg are his worst allergies (he's contact and airborne reactive) and his skin pricks have always been huge for these. Similarly, very high IGE on bloods.

It's generally recommended to only test for foods you suspect they're allergic to from reactions. Otherwise, feed everything. If your DS has already reacted to lentils but the prick result was small, I'd ask for a blood test. Depending on results, they may suggest you then try them at home, or come in for a food challenge in the hospital.

With regards the almonds, apparently that's a really rare nut allergy in the UK. Of course, an allergy is possible though.

With every new food, we just introduced a tiny bit at a time, watching closely. For ones we found scarier (like wheat and peanut) we did this parked in a hospital. This was before we had epi pens prescribed.

We gave Oatly Barista milk from age 1 (as well as breastmilk) but admittedly never had any issues with oats.