Confused - nut allergy - ask for referral?

[dooooo]

My 1 year old has had an allergic reaction to peanuts (redness, hives) but no trouble breathing. The GP said that there is no need for a referral because this reaction wasn’t anaphylactic and the skin prick test is very traumatic for a 1 year old.

However, I’ve read on anaphylaxis UK that an allergic reaction of such kind should still be followed up at an allergy clinic because it could turn out to be anaphylactic later.

Do I push for a referral? how traumatic is skin prick for a 1 year old? GP said to wait until DC was 2 or 2.5 but what if he has a serious reaction before then?

I would absolutely push for a referral.

My 1 year old didn’t even notice the skin prick test. It’s not like a pin, it’s kind of blunt.

Also - when my 1 year old had an allergic reaction to cashew and we took him to A&E they treated with piriton, referred him and made it really clear that the first reaction can be mild, the next one is the one that’s severe. This advice has been repeated several times at his allergy clinics. He has epipens. No sign of growing out of cashew allergy but he has grown out of the peanut allergy identified.

There is also the possibility of cross reactivity, which is being allergic to foods in the same family (beans, soya, legumes, lentils are all common foods with potential cross reactivity in peanut allergy). Pistachio allergy often goes with cashew allergy, and we wouldn’t have known my son was allergic without the skin prick test. You also need to ensure that you give foods in the same family that your child hasn’t reacted to, to prevent an allergy developing. Clinic is essential. Good luck x

Push for the referral, it's better to know! And avoid peanuts in future in case it does get worse as pp have said. My son had redness and hives after eating wheat and was diagnosed with an allergy via skin prick test.

He had it at 13 months old - of course he didn't quite understand and he was upset but I would in no terms describe it as traumatic. He had one again at 3 and barely noticed the nurse had started so I suspect he was more upset about having a stranger handle his arm the first time around than he was the actual test. The actual skin prick bit is over very quickly.

The NICE guidelines on food allergy in children state that skin prick testing and/or specific IgE blood tests should be offered if the history suggests an IgE mediated allergy. Hives would definitely be suggestive.
I would go back to the GP with the NICE guidance and insist on a referral for testing.
https://www.nice.org.uk/guidance/cg116
Skin prick testing can be unpleasant - it's more the itching from positive tests than the actual prick in my experience - but you need a proper diagnosis and management plan. Testing won't be dramatically different in another year and chances are there will be a significant waiting list anyway, so I would get on it asap.
In the meanwhile, it's probably worth being aware that peanuts are actually legumes not nuts so do take care to watch for any reactions with related foods - peas, beans, lentils, chickpeas etc.