No, newborns are not routinely screened for peanut allergies. For one thing, you need to be exposed to the allergen at least once before you make antibodies against it which can be measured by a lab test. For another, it’s just too cost prohibitive to make it a routine screen even for school aged kids. Kids will be tested if they display symptoms and it’s brought to the doctor’s attention. However, the allergy tests for food allergies aren’t very accurate, catching only about 60-70% of peanut allergies (with even lower numbers for some other allergens: wheat is down around 20%). So parents are faced with a conundrum: it seems like this food makes my kid sick, but do I pay for the test? If I do and it comes back positive, we avoid the food. If I do and it comes back negative, it might be in that large percent of false negatives, so to be safe, we’ll…avoid the food. What’s the advantage in testing, then?
Many parents, unable to afford or unwilling to trust the test, will instead perform an “allergy elimination diet” for self-diagnosis. If it’s done right, it’s actually not a bad way to go for food intolerances, but I think it’s stupid and dangerous for food allergies.
If you suspect your child is allergic - *truly *allergic, with a rash, hives, wheezing or airway closure - to *any *food, it’s just damned stupid to “challenge” him with that food on your own. You’re just asking for a life threatening incident. Remember, allergies tend to get *worse *with repeated exposure, and something that caused a rash last time might cause an airway to collapse this time. That sort of challenge should only be done under a doctor’s supervision, in a medical office with resuscitation equipment nearby, just in case the worst happens.
It’s a whole lot easier, and in some ways safer, to declare your child “allergic” based on some messy and not-rigorous observation of the last time he ate peanuts and got itchy (whether or not it was a day after he went to a park which may have had poison ivy growing around the trees…) At least, it’s easier on you. It’s not so easy on your child, or his teachers, or the families of his classmates and friends.
Not an issue in our school systems, thank God. Children are allowed to bring absolutely nothing with them at all except a water bottle in the hot months. No snacks of any kind are allowed. The entire nation of Japanese children do not die of hunger before school lunch. (Which is also a school-wide, non-negotiable lunch.)
Children with allergies are served the same menu with individually tailored substitutions that are checked by a parent each month in advance. The allergy menu comes covered with saran wrap with that child’s name on it and is made in a separate area of the main school lunch centre which serves the town’s schools.
I don’t know about peanut allergies, but there was an episode of Radio Lab that suggested that some modern chronicconditions might result from excessive sanitation. For example there are claims that being a host to hookworm parasites makes you resistant to symptoms of asthma.
My daughter - who is now eleven - is “allergic to penicillin” - I suspect that this is not the case at all. When she was eleven months old she had one of many reoccurring ear infections, went on amoxicilan and around that time had a modest rash. This MAY have been an allergic reaction, so we switched her antibiotics and have never confirmed (its on my to do list). It could have also been one of the gazillion other things that cause a small child to rash - a slight fever, different laundry detergent, her sleeper rubbing funny, etc.
Until she was six or seven they didn’t even want to test her. And I haven’t gotten around to it since.
Probably a good time to do so. They’re now finding that a whole lot of penicillin allergies are either false (that is, the patient was never allergic) or outgrown (yes, allergies can be outgrown, but again, safest to test with a doctor in the room.) Since there is a whole family of good, cheap antibiotics that they won’t give if there’s an “-illin” allergy in the history, you may end up paying a lot more and getting antibiotics with more unpleasant side effects when she needs them.
And if she *is *allergic to penicillin, she’s at an age where she’s more and more likely to run into situations of needing medical care when you’re not around, so she should be made aware of it and get a medic alert tag so that the docs and nurses know about it even if you aren’t there.
Thanks for fighting my ignorance. But if the cost of testing is high, that could help explain why it’s a higher percentage of overprivileged children who are being labeled as allergic, right?
I’m a father, not a mother, but if I show you the pictures of my daughter with her face swollen to three times normal size and the annual blood tests showing her allergen levels off the charts, can I get off your psychological issue list?
I’ve read your posts about your nutty ex-friend, but please don’t lump all of us parents of food-allergic kids in with them. We let our daughter go on play dates, to parties, etc. and the local EMTs are blissfully unaware of her plans. We just make sure all the caregivers are aware of her allergies and get briefed on what to do in case of a reaction. Unfortunately we’ve had an incident where a caregiver didn’t take their responsibilities seriously.
It’s tough though - last night she was at a birthday party where she couldn’t have the cake. I had a backup snack for her as usual, but she got pretty said about it. So please don’t assume when you hear “Our child has a peanut allergy” that the parent is making stuff up.
That’s a very good point. Without insurance, even a modest fee can be prohibitive, not to mention the time off work and transportation costs to get your kid tested.
When I wrote “too high”, I didn’t neccesarily mean that each test is very expensive (I don’t think the skin test (RAST) is terribly expensive, but blood tests are more expensive; both provide lots of false positive *and *false negatives), just that it’s too expensive to do on every kid for the slight benefit it might provide. There are lots of things I think we’d routinely screen for (like diabetes) if cost wasn’t an issue in modern medicine, but it is.
The prevalence of peanut/nut allergies is estimated anywhere between 1.5 and 3 million Americans. To compare, “only” about 340,000 people in the US have Type I diabetes. Yet it seems most people know one kid with diabetes, or are willing to believe that they exist in the numbers they do. And far more than that are allergic to nuts or peanuts. It’s really not that unlikely that one’s child would share a classroom with a person allergic to peanuts or nuts at some point. It would be surprising if they didn’t.
Also, remember that we just “know” more people than our parents did. If we didn’t have the Dope to share our stories on, you wouldn’t know about my daughter’s classmate Tristan, flodnak’s son or muldoonthief’s daughter, or the crazy lady Crafter_Man has to deal with. We’d each have one or two experiences with nut allergies in our life, and it wouldn’t seem like the problem was much bigger than it was when we were kids. Yes, numbers are going up, but perception is going up even more, I think.
Yes, Crafter Man, not every parent saying their child has a food allergy is insane, and neither are those of us who suffer food allergies.
It is the case that whack-a-loons like that lady DO make it much harder for those of us with legitimate problems with allergies.
As it happens I am allergic to tomatoes. Not only did we suspect that due to bad reactions after eating them, but it’s has been confirmed by medical testing as well. Know what I do when someone wants to order pizza? I just don’t eat it. I don’t request a “special” pizza, I don’t lecture a restaurant on utensil cleaning or cross-contamination, I just don’t eat pizza. Period. End of story.
IF I’m familiar with the restaurant in question and feel I can safely eat, say, the garlic toast or order a tomato-free salad (common options) I may do that, but if I’m not sure I just don’t eat. That is how sane adults with food allergies handle these situations.
Parents who insistent on keeping their children in an entirely risk-free anti-allergen bubble are actually doing their kids a disservice. That’s not the real world. Yes, children do need some protection but they also have to learn to deal with the wider world and protecting themselves, including saying “no” to food that might hurt them.
And yes, money and health insurance does impact who’s diagnosed and who isn’t. There probably is some overdiagnosing going on. There are also probably kids who vomit and/or wheeze after eating something they’re allergic to but may have no clue why the get sick so often (I was one of those kids for awhile).
Personally, I’d love to be retested. It was 30+ years ago I last had a thorough workup by a real allergist, and I know things have changed. Gee, maybe I’m not allergic to tomatoes anymore, I don’t know - but given that the last time I ate one (under protest - I actually have always loathed them, probably because they made me feel so awful) I damn near died. I’m not playing that sort of game with my health and life, I’d much rather be thought neurotic but live to a ripe old age. The thing is, my current health insurance, such as it is, will NOT pay for such a visit to a specialist, not unless I suffer a life-threatening reaction that lands me in the hospital. Og forbid they pay for testing to make my life easier or such a thing less likely to happen, right? At least my current doctor doesn’t think I’m nuts (though he did at first I think) and when I’ve had to have things done it’s been properly communicated that I am prone to having severe allergic reactions. Sometimes that means I don’t get general anesthesia for surgery, I get just a local (which can still be quite effective), or someone doing a procedure makes sure necessary items are on hand for an emergency. So far, nothing too serious has ever happened.
Meanwhile, I don’t get asked to dinner parties very often. I can live with that, as social eating can be very stressful for me, given a mistake could mean a life-threatening reaction (I’ve had a few, this isn’t theoretical). Meanwhile, I more or less insist my family and friends eat THEIR pizza, as my health problems should not be imposed on them.
Indicating to me at least that your first reaction to being told “my child has a peanut allergy” is that the parent is lying. I’m sorry you ran into a whack job, and certainly she doesn’t make life any easier for people with real allergies, but assuming that most people who claim to have allergies are lying isn’t a rational decision either.
There is absolutely NO food that can be guaranteed to never, ever cause an allergy in anyone. Although extremely rare, there have even been cases of people showing an allergy to human breast milk.
One problem I’ve encountered is some people have gotten a notion that only certain foods cause allergies. This is a problem for me when, for instance, someone hears I have food allergies then just assumes I can’t eat fish. I don’t have a problem with fish at all, I’m free to eat all I want. Now, tomatoes could kill me, or lentils, or green peas… and then these same folks say “Well! I’ve never heard of that!” Well, OK, now you have. There are people allergic to supposedly unlikely foods like white rice and lamb and so forth. Name any food you want, I’m pretty sure there’s a report someone of someone being allergic to it.
I was insanely lucky with my mushroom allergy. My parents didn’t like mushrooms, so I had never been exposed to them until I was in hospital at the age of 4 and was given a salisbury steak dinner that had them and I went into anaphylaxis. If I had been anywhere else [back in 1965 epi pens were not common] I would have died. And we didn’t have to pay for allergy testing . Win Win situation =)
