Food challenge coming up... can anyone help?

[GoingNuts]

Running to work, more later.  How old is your DD?

[QCmama]

She's 5 

I had to take her to the pediatrician this evening because she's had this nagging cold and it turns out that she has an ear infection and possibly a sinus infection, so starting tonight, she's on amoxicillin! I guess I need to reschedule (yet again)... her food challenge is scheduled for next Tuesday.

[ajasfolks2]

I'd want to reschedule.  You might want to double check with allergist, before you give up the appointment.  But I'm betting it's a no-go until off antibiotics and totally well.

[QCmama]

Definitely. I would be more comfortable with that anyway.
Another thing that's got me anxious is that her blood test, which showed she's negative for all tree nuts, was done at the end of July, so exactly 2 months ago. Would you repeat it at this point? I guess I'm just still in shock that it was negative!

[CMdeux]

Probably not, but that's me.  It would also depend upon her history with hazelnuts.

[QCmama]

Well, thankfully "just" rash-type reactions, but we've been insanely vigilant. The poor kid can't eat anything without me inspecting the ingredients, the website etc like a hawk.

I think the allergist plans on doing a skin test the morning of the food challenge. Is the skin test more accurate than the RAST? This is what I think they've told me, but not sure. If so, then what was the point of the blood test?

Thanks again for everyone's help!

[CMdeux]

Well, skin tests can remain positive (or just BE positive) in the absence of a clinical allergy, so... if the skin test is NEGATIVE, that's a really good indicator for a pass.

On the other hand, if you take daily antihistamines, bring them with you the morning of-- that way you can get those on-board immediately after that skin test.

(BTDT, btw.)

[QCmama]

Thanks for the tips! I had no idea about that re. the skin tests. Well, I take that back. The allergist did say that the skin tests are more reliable (my word, not his), but that adding a RAST test to the mix would paint a fuller picture and, if both negative, a food challenge would be warranted. At least now I know that he knows what he's talking about.

Can you tell I'm nervous for her?

[CMdeux]

I think that as a parent, you'd have to be pretty callous or at least unaware to NOT be going into a food challenge with at least some level of nervousness!!   

The trick is in breathing deeply (or appearing to) and seeming reasonably relaxed and calm in front of your child during the challenge.

_{This is where I confess that we never, ever challenge on a day that DH is out of town, right?  Because I want him to be a five minute ride from the ER.}

[Macabre]

But typically the general wisdom is that skin tests have a higher false positive than blood tests, so in that way they are less accurate.

However, if you have a skin test morning of and its negative, that's a good sign.

My thinking--and I could be wrong here--is that it may also help to gage reactivity/responsiveness that day. For instance, if they do a histamine or saline control with the SPT, that could also tell the doc where your kid is. It may not have a predictive value  for the challenge itself, but it may help to provide some information about how your kiddo is responding.

[QCmama]

Hi Macabre,
What doe that mean? I'm not sure what SPT is.

Thanks!

[Macabre]

skin prick test.

It's generally thought of as less reliable than blood tests. Though as CM mentioned, a negative result could mean some great things before a challenge!

[CMdeux]

Really I would probably go ahead with a challenge even with a small, positive wheal on a skin test.  As long as it wasn't, you know, HUGE like a nickel sized one or larger.

[Irene]

Don't know if the food challenge is over, but wanted to say that my son underwent a hazelnut food challenge 4 weeks ago using Nutella.  He had tested negative on a skin prick test and a very low positive on the RAST.  He passed the challenge!

[QCmama]

Hi Irene,
Congratulations! That's awesome! How old is your son?

My daughter's test is on Tuesday. I have a tub of Nutella in hiding at home (in hiding from the rest of us as much as from her...that stuff is addicting). My husband also found a package of roasted unsalted hazelnuts at a local market. I don't know if they're ok to use. It's packaged by the store, so they don't even know about cross contamination, so we'll see. I have it in case.

I assume your allergist was ok using Nutella vs actual hazelnuts, but do you know if that means your son can confidently eat an actual hazelnut or something other than Nutella with hazelnuts? I just want to cover all our bases so not sure if they'd try both at the test.

Thanks!