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When should I start testing my kids for allergies?

Question: When should I start testing my kids for allergies?

Answer: Even among allergists there is a debate about the usefulness of doing skin testing prior to one year of age.That's because the child's immune system is still developing and the information gathered from these tests may not be very reliable. After age one most allergist seem to agree that skin testing can be done in a useful manner, identifying the underlying cause of allergies.

If there is a serious underlying allergy to eggs or peanuts or if there was an episode of anaphylaxis it is critical to see an allergist. Anaphylaxis can result in the sudden onset of various symptoms including an itchy rash, throat swelling, and low blood pressure. In extreme cases, it can be fatal.

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In Canada, there is a national shortage of allergists which can lead to a wait of up to a year for an appointment.

Another option is to use blood tests to search for some allergies. (These tests are known as RAST testing.) This may be an option while waiting to see an allergist. However, it is ideal to see an allergist as soon as possible if the allergy was complicated enough to visit a hospital emergency room.

For patients with a history of serious, undiagnosed allergies the primary care doctor will prescribe an adrenaline kit with instructions on how to use it appropriately. Pharmacists will reinforce the correct use. The more educated parents are in the appropriate use of these kits, the less likely it will be that they may panic or use it incorrectly at a time of need.

Once the adrenaline kit is used, the patient should be seen also in the ER because there could be a further reaction.

In less serious cases, such as the only symptom being red itchy eyes upon exposure to an animal, the long wait of a year will not harm the child.

If a child has asthma, allergy testing is required sooner than later. An allergy may aggravate asthma symptoms and make it harder to breathe. When asthma is well controlled – usually with the appropriate use of medications – it means a child sleeps well at night, does not miss school, can continue to be physically active and does not end up with frequent unexpected visits to the doctor.

Send pediatrician Peter Nieman your questions at He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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Read more Q&As from Dr. Peter Nieman.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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