From the Guidelines
Allergy testing can be started in children as young as 4 to 6 months of age, especially for those with severe eczema, egg allergy, or both, as recommended by the most recent guidelines. This is based on the findings of a 2019 study published in the Journal of Allergy and Clinical Immunology 1, which suggests that introducing peanut-containing foods at this age can help prevent peanut allergy in high-risk infants. The American Academy of Pediatrics and other medical organizations also support this approach, as seen in a 2017 guideline published in the American Family Physician 1.
When considering allergy testing, it's essential to note that both skin prick tests and blood tests (specific IgE tests) can be safely conducted in infants when necessary. However, testing is most reliable and meaningful when there is a clear history of symptoms that suggest an allergic reaction. The medical history is key in diagnosis, and food allergy should be considered when allergic symptoms occur proximate to ingestion of a specific food, especially when symptoms occur on more than one occasion, as highlighted in a 2017 consensus report published in Pediatrics 1.
Key points to consider when deciding on allergy testing in young children include:
- The child's symptoms and medical history should guide the decision to perform allergy testing.
- Skin prick tests and blood tests are the two main testing methods, with skin prick tests providing immediate results and blood tests measuring specific IgE antibodies.
- Interpretation of test results by an allergist experienced in pediatric care is crucial, especially in very young children with immature immune systems and smaller skin surface areas.
- Positive test results indicate sensitization but do not always mean clinical allergy, and results should always be correlated with the child's symptoms.
In summary, the decision to start allergy testing in children should be based on their individual risk factors, symptoms, and medical history, with the most recent guidelines supporting the introduction of allergy testing as early as 4 to 6 months of age for high-risk infants.
From the Research
Allergy Testing in Children
Allergy testing can be started in children at any age, as stated in the study by 2. The decision to undergo allergy testing should be based on the presence of persisting or recurrent symptoms suggestive of an allergy.
Symptoms Suggestive of Allergy
Children with symptoms such as:
- Recurrent respiratory issues
- Skin rashes
- Gastrointestinal problems should undergo an appropriate diagnostic work-up, irrespective of their age, as recommended by 2.
Types of Allergy Tests
There are several types of allergy tests available, including:
- Skin prick tests (SPTs) 3, 4, 5
- Blood tests 4
- Patch tests 4 The choice of test depends on the type of allergy suspected and the age of the child.
Interpretation of Test Results
The results of allergy tests should be interpreted in conjunction with the child's medical history and physical examination, as stated in 5. A positive test result does not necessarily mean that the child has an allergy, but rather that they have been sensitized to a particular allergen.
Age Considerations
While there is no specific age limit for starting allergy testing, the study by 6 suggests that skin prick tests may be less specific for clinically significant food allergy in young children. However, this does not mean that allergy testing should not be performed in young children, but rather that the results should be interpreted with caution and in conjunction with other diagnostic tools.