Allergy test. Advice

[Em1705]

Hi,

For almost a year my 1 year old daughter has had a constant runny nose, shes coming out in dry patches on her skin accompanying by a rash sometimes and coughing during the night. Over the christmas period her face was a mess red, dry and rashy. We've been to doctors multiple times about her skin, nose and cough and all we get is its a viral infection, children can get x amount of viral infections a year etc. Ive mention about having a allergy test done but they are advising not too due to her age. In less than a year shes had conjunctivitis 3 times. However, I had her in doctors this week for her eye and a scabby rash that hasnt ever seem to clear up and they have reluctantly agreed to do an allergy test if that is what we wish. The doctor did turn round and say that he wouldn't put his 1 year old through it.

Any advice or experiences with this. Are we making the right decision about having it done?
Is it really as bad of a blood test if they are not wanting to do it?

What do you think she’s allergic to? The blood tests can only test whether she is allergic to x,y,z. There is no test for “what is she allergic to?”

Do you have any suspicions as to what you think she’s allergic to? Elimination is usually the first port of call, so for example if you think it might be milk or shampoo or washing powder, cut them out one at a time, and if her skin clears up you’ll have a better idea of what they need to test for.

This is nonsense. The skin prick test at an allergy clinic will test for a bunch of potential allergens and is very effective. They have loads of samples and you can bring your own. As a child I had to be tested with about 20 different samples in one test to pin down the allergies I had. Blood tests for allergies are usually pseodoscientific crap sold by dodgy pharmacists who sell herbalife on the side. Except the coeliac one.

Is it the blood test they are going to do or skin prick test?
DS had the blood test first at around 3 years old. It was quite distressing getting blood out of him at that age. They don't seem to want to hold young children down now, I felt it would have been less distressing if they had just held him. It might be easier with a younger child as you can hold them I would have thought.

When he showed positive for allergies we then had to be referred for the skin prick test to find out what it was.

It's probably easier with a one year old who can be held still and won't remember it. My child was tested for nut allergy around that age. It was a faff as first they tried to get the blood from a finger prick. However that wasn't enough so we had to go back for a proper blood test. When we finally got referred to the allergy clinic, they said the bloods were unnecessary and did skin prick tests.

As far as I'm aware its a blood test, they have said numbing cream will be provided. They said she was too old for a prick test which I'm very confused about that. She is under the dietitian for a possible milk allergy but after eliminating that she is still showing the same signs. Ive tried changing body wash, shampoo, washing detergent but nothing seems to be helping improve her symptoms. We've tried giving her anti histamine (prescribed by a doctor) but she just spits it straight back out no matter how we do it.

I do understand with her been in nursery she is prone to catching all kinds of infections. Its just awful hearing her coughing through the night waking herself up because of the build up of mucus (we have elevated her mattress a little which has helped with her cough)

That's not true. Specific IgE assays are done by perfectly legitimate NHS and private allergy clinics. Blood tests can be particularly useful in some circumstances, such as patients who can't stop antihistamines in the run up to skin prick testing.
Either way, you do need to have a shortlist (even if it's a long one!) Skin prick testing and IgE assays can only answer the question "Am I allergic to X, Y or Z" not "What am I allergic to" and of course they can only identify IgE mediated allergies, and there is a lot more to the immune system than that.
@Em1705 as others have said, you may be offered a blood test, skin prick testing or both. Bloods can measure the total amount of Immunoglobulin E in your baby's blood which can indicate she is allergic to something but not what. They can also measure the IgE produced in response to specific things. Skin prick tests measure the same type of response. I'd expect them to test for a bunch of common food and environmental allergens but if you suspect anything specific you might need to ask for a test. For example, I had been keeping a food diary and was sure my DC was reacting to lentils, which wasn't part of the standard test panel at our allergy clinic so it had to be requested separately. It is worth keeping a diary to see if you can identify any possible triggers. The other thing to bear in mind is that not all allergic reactions are mediated by IgE - there are other types of immunoglobulin and cellular mechanisms for allergic reactions so no one test is the be all and end all, the whole picture, including the test results need to be interpreted by an expert. My DC had only borderline skin prick and blood tests for egg but massive reactions on even the lowest rungs of the reintroduction ladder. Tests have their place but are only part of the picture and unfortunately don't always give the hard and fast answers we're looking for. Have you considered house dust mite allergy by the way? My DC's eczema cleared up very well once I took the recommended anti house dust mite measures and I thought my house was pretty clean beforehand,

Like @MrsAvocet a lot of my DC’s allergies were house dust mite. He also has Oral Allergy Syndrome and has a long list of food and animal allergies, but once we took measures against the dust mites, he was a different child.

Doctors do both IgE blood tests and skin prick tests.

The IgG ones you get in pharmacies/health food shops are useless, but IgE blood tests are regularly performed by doctors. So you can’t say avoid blood tests! It very much depends on the test!

I literally have to specify which allergens I want the ward to test on skin pricks (or indeed on RAST specific IgE testing).

It sounds reasonable to look into further testing if the symptoms have been ongoing for such a long time. Allergy tests in young children are quite common and can sometimes help identify possible triggers, although results are not always completely clear at that age. A simple symptom diary, including foods, skincare products, and environmental factors, may also help alongside any testing. Hopefully you are able to get some clearer answers and a plan that helps improve her symptoms.

DD2 had two rounds of allergy testing using bloods when she was between 18 months and two years.

It turns out she's a difficult draw, so it was protracted, multiple attempts because the first stopped working, etc., but honestly, it was horrific and left her traumatised. After the first, the sight of scrubs or going into a consulting room in a pharmacy or GP left her distraught. Six months after the second, she was due her flu vaccine (the squirt in the nose), and she was sobbing as soon as I said we were going to the hospital. She's four now and generally okay with hospitals/doctors, but I personally would be reluctant to do it unless it was really medically necessary. It's seldom a walk in the park, and if it's bad, it can be very bad.

For the antihistamines, a small piece of chocolate immediately before meds can help – the chocolate coats the mouth, so if you're speedy, they don't really taste it. Using a teaspoon can help if they've started reflexively spitting anything in a syringe.