What Parents Should Know About Child Allergy Testing

Allergy testing can be an effective way to identify the allergens that are causing your child's allergies; child allergy testing is not always recommended or medically necessary and so the decision to undergo child allergy testing needs to come from an informed parent-doctor partnership.

What Is Child Allergy Testing?

Child allergy testing consists of monitoring reactions to introduced allergens and/or testing the blood of the child for the presence of allergy antibodies (immunoglobulin, or IgE).

During child allergy testing, a child may be pricked, rubbed, scratched, or undergo intradermal injection with a small amount of one or more suspected allergens. The doctor will then watch for signs of allergic skin reaction (a raised bump or 'wheal') at the site of the injection.

Alternatively, the doctor may test the blood and look for specific antibodies that indicate an allergy to a suspected allergen.

What Types And Methods Of Child Allergy Testing Are There?

The most commonly used and trusted types of child allergy testing are allergy skin tests and blood tests.

Skin testing is often the preferred method of child allergy testing. Normally, child skin allergy tests are performed by droppering a small amount of allergen onto the test site and then lightly pricking or scratching the skin to introduce the allergen internally. The area will be monitored, and if a reaction results it indicates the child may have an allergy to that allergen. Alternatively, the allergen might be introduced by injection under the skin; this is called an intradermal skin test. More than one allergen may be tested for in one session at different points on the skin.

The blood test used for child allergy testing is called the Radioallergosorbent Test, or RAST. The ImmunoCap is becoming one of the more favored versions of this test. During RAST testing, the blood is marked with radioactive markers which highlight immune antibodies so that levels of IgE antibodies can be measured in response to an allergen.

Who Performs Child Allergy Testing?

Skin allergy tests are performed by Allergists-doctors who specialize in allergy testing and treatment. Allergists are skilled at performing tests and interpreting the reactions which indicate an allergy. Primary care doctors and pediatricians will refer children to an Allergist for skin testing.

RAST testing and other blood tests may be performed by an Allergist, but primary care doctors can also order RAST blood testing through your medical facility's laboratory.

When Is Child Allergy Testing Indicated?

Child allergy testing can be performed at any age when it is otherwise indicated. Both the American Academy of Pediatrics and the American Academy of Allergy, Asthma, and Immunology agree that age is not a barrier to child allergy testing and that children of any age can undergo child allergy testing when medically necessary.

This does not mean, however, that all children with allergies should undergo child allergy testing; in fact, child allergy testing is usually the last chosen course of diagnosis unless the potential for reaction is severe. Even in severe cases of allergy, child allergy testing may not be in the child's best interest as even a small amount of allergen may produce a life-threatening reaction.

There are several reasons why doctors do not look to child allergy testing as a first-line diagnostic tool.

* Allergy tests can deliver false-positive and false-negative results

* Positive reactions do not mean a child will experience an allergic reaction

* Child allergy testing can cause severe reactions

* Skin test results can remain positive as a child outgrows an allergy

* Not all allergens can be detected using child allergy testing; it is possible your child will have no positive allergy tests but will still have a very real allergy

* Blood tests may be generalized and misinterpreted to indicate an allergy when one does not exist

Generally, a doctor will not recommend child allergy testing if a child's allergies are only mild to moderate and are well-controlled with conventional methods. As an alternative, the doctor will help you plan a course of action for avoidance and identification. But there are times when child allergy testing is useful and positively indicated, including

* When a child has poorly controlled asthma or allergies

* When diagnosis is needed to specify an illness–i.e. when it is unclear if symptoms are the result of allergies, colds, flu's, viral infections, sinus infection/trouble, or asthma

* When a child is a candidate for allergy shots and it must be determined what allergens to treat for

In the end, even when child allergy testing is indicated, it should not stand as a diagnostic certainty on its own; child allergy test results must also be interpreted in the context of the child's medical history, symptoms, frequency and severity, and a complete, accurate, current medical exam. With all the factors favorably aligned, child allergy testing can be a very useful tool for doctors and allergists to devise the best course of allergy treatment for your child.

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