The evaluation of your child for food allergies begins with a thorough history. We ask you to bring a food history, including information about all reactions that have occurred when your child has consumed certain foods. We also assess your child's personal and family history of allergy. Next, we perform a physical examination to identify signs of allergic disease. Often the history is more important than the examination, and it is not necessary for us to see your child while they are having an acute reaction.
Initial food allergy testing is possible through prick skin testing and ImmunoCAP, a blood-based test.The prick allergy skin test is helpful in ruling out an allergy. With a negative test, we can be 95% confident that your child does not have an allergy to the specific food. However, a positive skin test is typically used to help confirm the diagnosis. A positive food allergy skin test is only 50% predictive of an actual allergy and has more importance when there is a history of an adverse reaction to eating the food in question. ImmunoCAP testing involves testing a small amount of blood and is typically used to track food allergies over time. Both methods of testing do not indicate how severe your child’s food allergy is or will be. Currently, there are no tests available to predict severity.
When we suspect a food allergy, avoiding the food is recommended. This is the best way to prevent and avoid reactions. We will provide you with instructions and extensive education regarding food avoidance, which is essential for your child's safety. Support groups can help you assess the day-to-day needs for your child as you begin to implement the necessary changes in your life and household.
We will also teach you how to manage accidental exposures and reactions. We provide an emergency plan and education regarding the use of oral antihistamines and auto-injectable epinephrine. Everyone who has responsibility to care for your child must be instructed on avoidance and emergency medications.
We will follow up with your child on an annual or semi-annual basis. During follow-up visits, we review any new health concerns. Your child's plan for an accidental ingestion will be updated. Testing can confirm if your child has outgrown their food allergy and can be performed by our specialists.