In thinking that my GP's advice was wrong?

[TheHelpfulHiker]

DS2 is four and we suspect he has a peanut allergy. When he was a toddler he had a severe reaction to peanut butter (ended up in A&E although was over pretty quickly). On another occasion we were at a party with a bowl of peanuts on the table and he came out in hives, although he didn't touch them, others around him did so there would have been traces on the table etc. We have subsequently done a skin test with some peanut butter and again his skin reacted. Now he is starting school so we need to formalise it and find out how severe it is, what we need to do to manage it etc. I know we should have done it sooner, but I took him to our GP this morning and the general consensus is that we can't be sure it's peanuts as there are many ingredients in peanut butter and even peanuts have salt and other preservatives(?) on them. SO my GP told me to go home, give him 2-3 peanuts (after boiling them so there is nothing else on them), have some piriton to hand and call 999 if he has a bad reaction. AIBU or is that nuts? (pun intended). In the end we gave him half a nut, his face went blotchy and came out in hives so I dosed him up with piriton and it subsided. We have another appointment on Thursday. Fingers crossed we get further! If any allergy parents have any tips on what to say and how to make some progress I'd be so grateful.

Shocking advice! Our dd is 3 and had only had mild reactions e.g. rashes after having small amounts of food containing peanuts. My GP referred us to allergy clinic based solely on this. Any testing should be done in controlled circumstances or under consultant advice and with the necessary medication handy in case of a bad reaction. I know you have said you are changing gp already but please report this because it is potentially fatal advice and needs addressing.

Mum of an allergy child here. Peanuts, seven different types of tree nuts and eggs. We carry 2 epi pens and antihistamine everywhere. Sorry you are going through this.
Firstly, I have heard of medical advice to ‘try at home’ but in my experience this has been in the absence of a previous severe reaction.
Secondly, what was your follow up after the skin prick test? I’m not sure I understand why this is being dealt with by the GP rather then the paediatric allergy specialist/consultant. Are you in the UK?
Some children do grow out of allergies, although this is less common with nuts. This may be why your GP has suggested trying exposure again - to understand whether your child is still reacting, given it appears to have been a number of years since your initial hospital admission.
In our case my child’s egg allergy was diagnosed by a blood test under the age of 1 as the reaction was immediate and severe. We were advised to avoid all nuts until age 3. The nut allergies were then formerly diagnosed initially by a skin prick test and subsequently a blood test was ordered to check a large variety of nuts which showed positive for eight types.
It sounds like your child is sensitive to smell (airborne). Our child can have a reaction if they are in the same room as a person eating nuts.
My advice would be initially to go back to the GP and explain the reaction that occurred after trying peanut and insist on a referral to a paediatric allergy specialist and then get the skin prick test followed up with a blood test.
As soon as we realised my child was reacting to smell they were prescribed Epi pens by the consultant over the telephone (which was made out by the GP surgery), this was before even having a blood test.
Feel free to pm me. Good luck with it.

I would ask for a referral and proper opinion. My DS (now 22) reacted to peanuts age 7, face swelling, wheezing, etc - I gave him some antihistamine and it subsided. As we were in the process of moving house and didn't have a GP we just avoided him having them. A year later we had a curry and later discovered is had peanuts in it as DS reacted again.

This time visited GP, had a skin prick test and a blood test which both showed it 'was unlikely' that he had an allergy to peanuts or any other nuts!

I insisted on the peanut test at the hospital where they start by putting some peanut butter on your face, getting closer to your mouth. He didn't react until he ate a tiny bit of the end of the spoon, within minutes his face was swollen and he started wheezing and the nurse said to me 'are you sure he hasn't rubbed some in his eyes - because he had not blistering inside his mouth they didn't believe it was caused by the peanuts! They waited 45 minutes, until the doctor came, before giving him any antihistamine by which time his eyes were almost closed. They eventually agreed to give him a Epipen for future use and it took until the next day before he felt back to normal. He has avoided peanuts since and guess what, no other reactions.

Not all people react the same way and allergies are not always treated correctly, DS does have asthma, hayfever (and pet allergy self diagnosed after noticing his reaction to our cat after being away from home) so peanut allergy was also likely and I can't understand how they think a direct reaction wasn't real.

Fuck sake. That GP should be struck off. "Give him nuts and dial 999 if there's a problem." Christ.

Sorry to hijack but my dd is allergic to peas and lentils. She had a peanut challenge that was done in hospital but was fine, however the last time I gave her peanut butter she came out in a rash around her mouth. The worst reaction is to peas , she wheezes and coughs even if they're the other side of the room!
Really scary as it can change anytime.

My child had an initial allergic reaction (hives) and the GP was pretty crap, but we went through the HV and she referred straight to dietician who referred straight to allergy clinic.

It was 4 months between the initial reaction and allergy testing for us.

I'd go back and insist on a referral to allergy clinic, and make a complaint about the GP. Maybe an organisation like Allergy UK can help with a complaint?

The allergy doctor we saw said they would only do a food challenge where they actually feed the child a bit of the allergen/suspected allergen in hosptial under close monitoring.

Not saying it’s correct advice. But I’ve heard this before, although they suggested the person made sure they were in range of A&E if they did.

Okay, wait, I'm wrong. That's how you can prevent a peanut allergy from forming in infants. Once kids have it, I don't think it helps. Sorry!

Your GP sounds dangerous and incompetent! I hope that you report them!!!

Durgasarrow - I think you're thinking of children without allergies? Then it's a good idea to expose them to any potential allergies as early as possible.

When children have an allergy they need to avoid it as reactions can be fatal - and any exposures are controlled and under medical supervision.

@durgasarrow in my experience any desensitisation to nuts should be performed in a controlled environment and there are several factors that preclude individuals from participating - for example if they have allergic reactions to other substances. I know this is the case in the UK as I have enquired for my child.
I suspect the GP advised exposure to the allergen to confirm that the child is still reacting, as the initial hospital admission was a couple of years ago.
I still find this approach surprising given the allergen is peanut.

I fully appreciate that my experience is nowhere near as serious as a peanut allergy, but my son developed a cows milk protein allergy at 12 weeks. My GP suggested the exact same thing - go home and give him cow's milk for a week and see what happens. Fuck. That. No way was I giving him cow's milk when I already knew what the issue was. She actually told me that she refused to give me CMP free milk on prescription because it "costs a lot of money for the NHS". I told her that there was absolutely no way I was doing that and changed GP surgeries immediately. In hindsight I really wish I'd reported her!
I hope you get the referral on Thursday OP and I'm sorry you're having to deal with this!

Appalling advice! And boiling them could make it even more dangerous. When my child was small and very allergic, it was explained to me by the hospital consultant that some allergens change when cooked. That's why some allergic people can eg have eggs baked in a cake, but not lightly scrambled forexample, because the cooking process 'loosens' the allergenic properties. With peanuts, I was cautioned that the cooking process 'tightens' the allergens, and renders the substance MORE of a risk.

Posted too soon! Thank goodness you didn't heed his advice and kill your kid! (My DS has peanut anaphylaxis - and all other nuts and kiwi - and strangely, horses.....) I can't stop thinking about what could have happened if you hadn't listened to your intuition.

Durga you clearly know Jack shit about the treatment of peanut allergy. Exposure therapy starts with microscopic amounts of peanut exposure under carefully controlled medical conditions. Microscopic. Carefully built up over months for the 50% of suffers that respond positively to the treatment. You dont just chuck a few peanuts down them and hope they dont die.

@BarbariansMum 😂 great post!

Thanks @millie2017 , I appreciate your advice. I'm sorry you have to go through a situation that is much more serious than ours. To answer we are in the UK. When I said skin test it wasn't under medical supervision. We did it at home as it's been a couple of years since his last reaction and we wanted to make sure he is definitely allergic before chasing it up with doctors. I naively thought that after today's appointment we would be referred to paediatric allergy clinic, wasn't expecting it to take this turn!

@cathopeful that makes it even more scary! I m so glad I didn't chuck a load of peanuts down his throat. I regret giving him the tiny bit we did. I should have argued but hindsight is a wonderful thing isn't it!

No way would I do that.

If you decide to do it I suggest once you have boiled the nuts you drive to a and e then give hdc the nuts outside the hospital

It sounds like he has a potential IGE allergy to peanuts which means there is a risk of an anaphylactic reaction. Your GP should have referred you for allergy testing and absolutely not suggested you try giving peanuts at home, especially when there was already a history of hives on contact.

There are allergy clinics that can do either blood test or skin prick testing. That's what you need at this stage. You may also be referred to a dietician.

@thehelpfulhiker that makes more sense.
On Thursday describe the reaction to your GP and ask for them to make the referral to your local allergy clinic.
Be prepared for them to conduct the skin prick test on your first appointment. If this is positive for peanut they will most likely follow up with a blood test (in which they will test a wider variety of nuts). When you are referred for the blood test ask for numbing cream on prescription and get this in advance, it makes a massive difference.
Also make sure they are aware that your child has had an airborne reaction, as this will give them an indication of the sensitivity of the allergy.
And please do mention the allergy to your child’s school. They will put it in his notes. Even if it is a nut free school. My child attends a nut free school and they have still had an instance of having to call an ambulance because a child had Nutella in a sandwich brought in from home.

I might be completely wrong on this but I understood that a reaction can come back after the initial reaction subsides (ie a couple of hours later) so please keep a close eye on your son for the rest of the day.

Reckless advice.

My dd had 1/2 a peanut aged 4 and we ended up in A&E .

She gets hives if she touches anything with peanut in.

How on earth did the gp know that he wouldn't go into anaphylactic shock!?