To give my v slightly positive CMPA milk based products?

[IndigoTea]

Hi

My 6 month old DS just got blood results back which show no major allergies thankfully, however when cows milk protein allergy was tested separately it came up positive slightly (2 out of 6). There appears to be conflict amongst peadetricians as to whether babies should be introduced to cows milk slowly when they have an intolerance (like in baked goods etc). I am tempted to try giving her some cows milk based products like bread, muffins etc and then if that's ok try other things and maybe even some formula?

(My GP is rubbish btw and doesn't have any useful advice to give and I'm waiting for a peadetrician referral but to be honest don't have much hope in them either)

My point was that saying "allergy tests are pretty rubbish" is not especially helpful to a person whose child has tested positive (presumably, according to her paediatrician) and been given a score on a scale we are not sure of (but which I suspect is the standard old-fashioned RAST 0-6 scale whereby 0 indicates is least reactive while 6 is most reactive). We don't know the ranges.

It is unwise in the extreme to imply to a person wondering what the OP's wondering, that allergy tests are usually nonsense.

By positive rast test I meant, meets the positive predictive value threshold for a particular allergen. For milk this is usually set at class 3 on the RAST scale (varies depending on who you speak to). But we don't know if this is the scale the OP is referring to when she says 2 out of 6. Once the PPV is reached for a particular allergen, then there is a circa 95% chance that the child will indeed have an allergy to that particular substance.

I am not a doctor, nor a HCP, but my son had CMPI and we went through all this. I did my research and listened to the paed. I also have a friend with a child with very severe (empirically evidenced) allergy to lots of foods and she and I have talked at some length about this issue.

ppv threshold

Where did you get the 95% from?

The Journal of Allergy and Clinical Immunology
Volume 100, Issue 4 , Pages 444-451, October 1997

"For egg, milk, peanut, and fish allergy, diagnostic levels of IgE, which could predict clinical reactivity in this population with greater than 95% certainty, were identified: egg, 6 kilounits of allergen-specific IgE per liter (kUA/L); milk, 32 kUA/L; peanut, 15 kUA/L; and fish, 20 kUA/L. Conclusions: When compared with the outcome of DBPCFCs, results of CAP System FEIA are generally comparable to those of skin prick tests in predicting symptomatic food hypersensitivity. Furthermore, by measuring the concentrations of food-specific IgE antibodies with the CAP System FEIA, it is possible to identify a subset of patients who are highly likely (>95%) to experience clinical reactions to egg, milk, peanut, or fish. This could eliminate the need to perform DBPCFCs in a significant number of patients suspected of having IgE-mediated food allergy. (J Allergy Clin Immunol 1997;100:444-51)."

Is this now considered obsolete? If so it is puzzling that the the American Academy of Allergy, Asthma and Immunology are still referencing it

That blog you linked to doesn't seem particularly scientifically well-informed. It sounds like a desperate parent, who is fed up with the medical profession, and quite rightly so as they have not (apparently) given her very helpful information. I feel for her, but what she is presenting is not scientific evidence, is it??

No it doesnt but I was just doing a rough search from my phone.

See Ive been told different by different by different allergy specialists,
But thats nothing new in the allergy world.

Still dont believe its as high as 95% or even near.

Fine, but you were really quite rude upthread but that seems to be par for the course on AIBU.

I think OP would be better placed posting on allergy boards. Hope all goes well whatever you decide Indigotea.

Actually, I think you came in here rude in the first place.

You basically poo pooed information that the a OP had been given in a patronising way.

So yes, back at you.

I think the problem for the OP is that she has not seen a suitably qualified HCP to offer advice. Is that right? So, in the meantime it is surely best to err on the side of caution .

OP I hope you get the help from the HCP you need. I generally think it best to follow their advice and if they haven't given advice that seems sensible, seek a second opinion. Even if it is 'just' CMPI as opposed to CMPA then it's best to go carefully IME. A too-soon reintroduction of CMP in my son's case led to eosinophilic oesophagitis and was the suspected cause of his anaemia. And he does not have a true IgE mediated allergy.

OhforDucks I think you have misibterpreted what I have said. But I stand by my assertion that it's really not a good idea to second-guess blood results and nor is it sensible to say blood tests are no use - the OP needs to see someone who is professionally qualified in this field.

No fair enough I agree there Ragua.

I didnt say the blood tests were no use though, if I thought that I would have pinned down my son at 5 months, one year and 18 months old so they could take his blood.

Its a guide but it isnt a very reliable one.
Not as reliable as we would all like it to be, I think we can agree on that.

*wouldnt have

Thanks everyone!

I will wait to talk to a peadetrician and then decide what to do. It was the RAST scale which came up at 2, which just about a positive.

I would also ask about a paediatric dietician referral. HV can do that if you don't want to wait for paediatrician to do so,