Allergy Testing in Infants: What Parents Need to Know - Pediatrics

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Understanding allergy testing in infants can be quite complex, especially for parents who are navigating the early stages of their child's health. In your case, your son is only two months old, and you have already taken steps to assess whether he has an allergic predisposition. Here’s a detailed explanation of what you need to know regarding allergy testing and the implications of the results you received.


Allergy Testing Basics
Allergy testing in infants typically involves either skin prick tests or blood tests. The blood tests measure the presence of specific IgE antibodies that indicate an allergic response to certain allergens. The number you received, 28.5, likely refers to the total IgE level in your child's blood. In general, a total IgE level above 24 kU/L can suggest an increased likelihood of an allergic condition, but this is not definitive for specific allergies.


Understanding the Numbers
1. Total IgE Levels: The total IgE level is a general marker of allergic predisposition but does not specify which allergens your child may be sensitive to. The threshold of 24 kU/L is a common reference point, but different laboratories may have varying reference ranges. Some doctors may consider levels below 100 kU/L as normal, but this can depend on the specific tests and the context of the individual patient.

2. Specific IgE Testing: To determine if your child is allergic to specific substances (like milk, eggs, or seafood), specific IgE tests are required. These tests measure the immune response to individual allergens. If your doctor did not provide specific values for these allergens, it may be because they opted for a total IgE test first, which is a broader screening tool.


Eczema and Allergies
Your child's facial redness, diagnosed as atopic dermatitis (commonly known as eczema), is often associated with food allergies and environmental allergens. It is important to note that while eczema can be a sign of allergic conditions, not all children with eczema will have food allergies. The relationship between eczema and food allergies is complex and varies from child to child.


Why Only One Number?
The reason your doctor provided only the total IgE level could be due to several factors:
- Initial Screening: The total IgE test is often used as an initial screening tool. If the level is significantly elevated, further testing for specific allergens may be warranted.

- Age Considerations: At two months, your child’s immune system is still developing, and many tests may not yield reliable results. Doctors often prefer to wait until the child is older before conducting more specific tests.

- Clinical Judgment: Your doctor may have determined that the total IgE level was sufficient for the moment and that further testing could be done later if necessary.


Next Steps
1. Follow-Up: It is advisable to follow up with your pediatrician or an allergist for a more comprehensive evaluation. They may recommend specific IgE testing based on your child's symptoms and family history.

2. Monitoring Symptoms: Keep a close eye on your child's symptoms, including any reactions to foods or environmental factors. Documenting these can help your healthcare provider make informed decisions about testing and management.

3. Management of Eczema: In the meantime, managing your child's eczema is crucial. This can include regular moisturizing, avoiding known irritants, and possibly using topical treatments as prescribed by your doctor.

4. Education: Educate yourself about potential allergens and how to introduce new foods safely. The American Academy of Pediatrics suggests introducing allergenic foods to infants around six months of age, but this should be done under the guidance of your pediatrician, especially if there is a family history of allergies.

In conclusion, while the total IgE level provides some insight into your child's allergic potential, it is not the complete picture. Further testing and monitoring will be essential in understanding your child's specific allergies and managing their health effectively. Always feel free to ask your healthcare provider for clarification on test results and the next steps in your child's care.