Learn what to expect when taking your child to an allergist, including the tests that an allergist may perform.
If your child's primary care doctor suspects that your child has an allergic condition, such as a food allergy, your child will be referred to an allergist.
You may also be interested in seeking out an allergist on your own if your child shows symptoms of an allergy.
Learn more about when to take your child to an allergist from Children’s Hospital of Orange County (CHOC):
At the allergist, your child could be tested for different allergies, and if the allergist does find that your child has an allergic condition, they will help you and your child manage it. Here's what you can expect when taking your child to an allergist.
What Is An Allergist?
An allergist is a doctor who specializes in the diagnosis and management of allergies.
An allergist (also called an allergist/immunologist) is a physician certified in either pediatrics or internal medicine, who has completed an additional two years of accredited training in the area of allergy and immunology. They have also passed the rigorous allergist's exam given by the American Board of Allergy and Immunology.
The role of an allergist is to perform tests to discover whether someone has an allergy, and to help people manage and treat allergic conditions involving the immune system.
Some of the conditions that allergists provide treatment for include:
- Food allergies
- Hay fever
- Sinus inflammation
- Insect sting allergies
- Medication allergies
- Seasonal outdoor allergies (such as grass and pollen allergies)
- Indoor allergies (such as pet dander allergies and dust mite allergies)
- Immune disorders that lead to severe infections
Nearly all allergists are trained in both pediatric (children's) and adult allergy. But while some allergists serve both children and adults, other allergists choose to specialize in pediatric allergy.
Preparing For The Allergist Visit
If your child is about to visit the allergist for the first time, these tips can help you prepare for your visit:
- List or journal all the symptoms your child is experiencing.
- Go into detail about when and how often they have these symptoms (seasonally? After being exposed to a cat? After eating a certain meal?)
- Be as detailed as possible when logging symptoms.
- Be ready to tell the allergist about any medicines you've tried using to manage your child's symptoms.
- Know your family history of conditions like food allergies, eczema, asthma and hay fever.
- Don't give your child antihistamine for at least three days prior to the first visit, in case they're tested for allergies during this initial visit.
- Also, don't give them antihistamine for at least three days prior to any later visit where allergy testing is expected.
- Antihistamines can interfere with the results of allergy testing.
- Some types of antihistamines include allergy pills, liquid allergy medication, eye drops and nasal sprays.
Your Child's Visit To The Allergist
What to expect when you take your child to an allergist for the first time?
Usually, the allergist will start by asking for your child's complete medical history. This will include what potential allergens your child has been exposed to, what their symptoms are and when they seem to be triggered, and what medicines they are taking. They will also ask if anyone in your child's immediate family --- parents or siblings --- has an allergic condition, such as a food allergy, hay fever or eczema.
Share all the symptoms your child has, however mild you think they are, and don't be afraid to ask the allergist questions. This will help the allergist gather the information they need to help your child.
As Board-Certified Allergist Dr. Ronald Ferdman (Children's Hospital Los Angeles) explains, "[Allergists] can diagnose 80-90 percent of allergic problems just by speaking to the family and finding out the symptoms, the type of symptoms, and the circumstances surrounding the symptoms."
During this first visit, the allergist will likely also check your child's eyes and nose, and listen to your child's lungs.
For a definitive diagnosis of an allergy, though, including a food allergy, allergy testing is needed. So, the next step usually involves the allergist giving either a skin prick test or a blood test to your child.
Skin Prick Test
During a skin prick test, your child's forearm or back is pricked with a needle containing a small amount of a suspected allergen. Then, the allergist monitors your child to see if an allergic reaction develops around the area where their skin was pricked. Any allergic reaction that develops on the skin will look raised or red. The skin prick test can be used to test for both food and non-food allergens.
Skin prick tests take about 20 minutes to show results, and can get itchy, so make sure that your child has an activity on hand, or that you can distract your child in some way, as you both wait for results.
Nemours shares more information on skin prick testing:
During a blood test, your child's blood is drawn and checked for IgE antibodies that respond to specific allergens.
When someone has an allergy, their immune system over-defends the body against a specific allergen (such as food or insect sting venom) and treats that allergen like a harmful virus or bacteria.
If they have a traditional food allergy, their body produces special IgE antibodies that prime their immune system to defend against the proteins from the specific food(s) that they are allergic to.
For example, if a child is allergic to peanuts, they produce peanut-specific IgE antibodies that trigger an immune system response to peanut protein.
So, checking for the presence and type of these IgE antibodies in the blood is one way to determine whether your child is allergic to a food.
Blood tests can also check for IgE antibodies to insect sting venom. People with insect sting allergies produce IgE antibodies to the venom from a specific insect sting (bee, wasp or hornet sting).
Blood test samples must be sent to a lab for analysis, so it will take a few days for you to receive the results.
(Even though allergy testing is the next step after checking a child's medical history, skin prick or blood testing isn't always done during the first allergist visit.)
Oral Food Challenge
If the allergist is testing for a food allergy, and the results of the skin prick test or blood test aren't conclusive, the allergist may ask to perform an oral food challenge. An oral food challenge is the most accurate way to diagnose a food allergy.
During an oral food challenge, your child will eat very small amounts of a food that they have a suspected food allergy to, in front of the allergist and in a clinical setting. The dosage of food will gradually increase over time. Throughout this process, the allergist will closely watch to see if your child develops an allergic reaction to that food. If your child develops a reaction, they have a food allergy to that food.
If Your Child Has An Allergy
If your child has an allergy (based on test results), they will need to visit the allergist regularly, approximately every 6 to 12 months. Their allergist will help you and your child manage the allergy by instructing you on how to avoid your child's allergens.
If any treatment is available to help your child manage the allergy, your allergist will also discuss this. Every type of allergy is different, so treatment options will vary based on your child's diagnosis. However, for food allergies, the treatment options are limited.
If your child has a food allergy, the allergist might also recommend that your child undergo more oral food challenges as they grow, to track whether your child still has the allergy. After all, some allergies (such as milk and soy allergies) are often outgrown.
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