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Dealing with Childhood Allergies: Testing

A child’s severe allergic reaction to food is terrifying for two reasons. First, it can come on suddenly—hives, swelling and shortness of breath can all come on in a matter of minutes. Secondly, it can be difficult to pinpoint what exactly causes a reaction.

Allergies and intolerances can arise without warning and potentially disappear a few years later in adolescence. A food that might have been perfectly safe one week could pose an unknown risk the next. And because cross-contact (when an allergen is inadvertently transferred from a food containing an allergen to a food that does not contain the allergen) is so common in food preparation in Thailand, it is sometimes borderline impossible to determine what cause the problem in the first place. A child might have an allergic reaction to a slice of pizza simply because, unbeknownst to the family, it came into contact with a piece of squid.

If your child has had an allergic reaction, your first step is to contact a qualified specialist.

Skin tests

Fast and relatively reliable, this is the go-to method of choice for most doctors. In this test, the doctor will prick the patient’s skin and apply a concentrated drop of the possible allergen. If the patient is allergic, a rough, irritated welt will appear. It’s a fairly unpleasant process, especially for young children, but it can provide life-saving information.

Blood tests

Slightly more time consuming than the traditional skin test, a blood test can help find allergens, but cannot always determine the severity of an allergy. In this procedure, doctors collect a blood sample, send it to a laboratory, and see how it reacts to different allergens. The results can take a couple of days – week to come back.

A controlled food test challenge

Although this test can be potentially dangerous in patients with severe allergies, it can be useful to either confirm or refute a skin or blood test. It can also help establish whether a child has outgrown a particular allergy as they have gotten older. In this test, the doctor will ask the patient to eat a small sample of an offending substance either as food or as a small capsule.

Under no circumstances should you or your child undertake this test at home. Although your child might prefer to sample things on their own in order to skip a visit to the doctor’s office, there is no way to guarantee that this test will be safe. It should only be administered with medical equipment and professionals at the ready, just in case.

An elimination diet

This is not recommended for young children, especially if they have displayed severe allergic symptoms in the past. However, since the standard allergy testing procedures can cause substantial physical discomfort, doctors sometimes suggest this as an alternative. It should be used primarily to help isolate a non-life-threatening allergy, food intolerance or sensitivity. It is not a substitute for a hospital-administered test.

Essentially, doctors will ask a patient to avoid certain common trigger foods such as gluten, soy or nuts and keep track of any changes. During this time, patients may be asked to keep a diary of any symptoms they may experience.

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Wasu Kamchaisatian, M.D. Summary: Pediatrics Pediatrics