Does your baby have a food allergy? Let's talk about the tests that doctors use to find out (Food Allergy Testing)!

Do you or your little one feel anything strange or uncomfortable after eating a meal? Have you ever experienced itching, red rashes, or difficulty breathing after eating a certain type of food? These could be signs of a food allergy . So, let's talk about how doctors can diagnose food allergies and what tests they do, right? There's no need to be afraid or worry unnecessarily about these things. But knowing this information will be very useful for you.

How do doctors test for food allergies?

Usually, a doctor, especially a doctor who specializes in allergies – we also call him an "allergist" – uses two main testing methods to confirm whether a food allergy is present. These are skin tests and blood tests . In some cases, the doctor may decide to do both of these tests. This is determined by considering several factors, such as the patient's condition and the nature of the symptoms.

What is a skin prick test? How is it done?

This is not as big or complicated as you might think. It is a very simple test. Imagine that you suspect that your little baby is allergic to something when he drinks milk. Then the allergist or a trained nurse will do this test like this:

1. First, thoroughly clean the skin on your or your baby's forearm or part of the back.

2. Then, the allergen contained in the food you suspect (in our example, milk) – that is, the substance that can cause an allergy, we call it an "allergen" – is taken as a very small amount of it in the form of a liquid, and the liquid is brought into contact with the skin using a very small, small object like a pin, or by making a small scratch on the surface of the skin. This is not a big pain, it feels like a very small tickle, like a mosquito bite. There is nothing to be afraid of.

3. Apply the liquid to your skin like this and wait for about 15 minutes.

4. Now the most important thing. If the area where the "allergen" liquid was applied becomes red, slightly swollen, and a small blister-like bump (this is also called a "wheal" by doctors) appears, it gives some indication that there may be an allergy to the food in question.

5. Then, the doctor or nurse will use a ruler to accurately measure the size of the wheal and the surrounding red area and record it.

Now imagine, if you suspect that you are allergic to not just one food, but several types of food, or if it is difficult to determine exactly which food is causing these allergic symptoms, the doctor can test your skin by putting several different "allergens" on it at the same time.

After the skin test, you may scratch the area where the test was done for a short time. This is normal. However, the itching usually subsides within 30 minutes. If your baby is experiencing excessive itching, the doctor may give you an antihistamine or a topical steroid cream to apply to the itchy areas. This will help reduce the itching quickly.

What exactly does a blood test look for?

In some cases, in addition to the skin test mentioned above, or if there are certain reasons why a skin test cannot be performed (for example, someone with a severe skin condition or someone taking certain medications), the doctor may also recommend a blood test.

This involves taking a very small blood sample from you or your baby and sending it to a laboratory for special tests. The main thing is to check if the blood contains "IgE antibodies," which are produced by our immune system against specific foods.

Simply put, these IgE antibodies are a special type of protein that our body's defense system, the immune system, makes when it mistakenly identifies certain foods as "bad" or "enemy," and tries to fight them off. So, if a person's blood is found to contain these IgE antibodies to a certain food, it means that there is a possibility that they are allergic to that food. It's just a clue, just like the results of a skin test.

How do doctors interpret test results? This is very important!

Here's something you need to keep in mind. Just because a skin test or blood test results in a " positive" reaction to a food does not mean that a person is 100% certain that they are allergic to that food. It only indicates that there is a possibility of an allergy.

Think about it this way. Some people are born with very sensitive skin. Even if their skin is slightly irritated by something, such as something that is not a test substance, it may turn red, swell a little, or even blister. It doesn't have to be an allergy. Also, some people may have IgE antibodies in their blood to a certain food, but they may not show any allergic symptoms when they eat that food. We call this "sensitization," which is different from "allergy."

Therefore, a doctor will never make a final decision about whether someone has a food allergy based solely on these test results. He or she will definitely ask you many other things, such as:

• What specific symptoms are you or your baby experiencing? (e.g., itching? rash? difficulty breathing? stomach upset?)
• How long after eating the food do these symptoms appear? (Minutes? Hours?)
• How severe are the symptoms? (Is it just a little itchy? Or is it so severe that your whole body swells up and you can't breathe?)
• Does anyone else in your family (mother, father, siblings) have this type of food allergy or other allergies (e.g. asthma, dust allergy)?

A doctor comes to an accurate conclusion about a food allergy only after examining the patient's complete medical history, the nature of the symptoms, and the test results.

What is an Oral Food Challenge? Is it dangerous?

Now imagine that the results of both the skin test and the blood test mentioned above are not very clear. Or, if your baby had a food allergy when he was a child, and now that he is a little older, you want to know for sure whether that allergy has disappeared, that is , "outgrown", the doctor may suggest another specific test. This is what we call an "oral food challenge" .

Here's what happens:

1. The food that is suspected of being an allergen (potential food allergen) is introduced in a very small amount, perhaps about one-tenth of a teaspoon, and gradually increased over time.

2. All of this is done under the direct and close supervision of a doctor. The doctor or trained medical staff will be watching closely for any allergic symptoms. Things like pulse rate, breathing pattern, and skin changes are constantly monitored.

3. Never attempt to perform this test at home. This should be done in a doctor's office (clinic) or hospital, which is a place that has all the necessary facilities to treat an emergency. Because, in the event of a sudden, severe allergic reaction, such as "anaphylaxis," which can be life-threatening, there should be emergency medicines and trained doctors and medical staff available.

This is very important: Never, for any reason, attempt an "Oral Food Challenge" at home without medical supervision, okay? Because food allergies can sometimes be incredibly dangerous. It can even be life-threatening.

Most often, this "oral food challenge" test is done to confirm whether a previous food allergy has now cleared up, meaning that there is no problem eating that food now. For example, a baby who was allergic to eggs as a child may naturally outgrow that allergy over the course of a few years as they get older. So this test is very useful for finding out exactly that.

What happens next if a test confirms an allergy?

Okay, now let's say that the tests mentioned above have confirmed that your baby or you have a food allergy. Don't panic at that point, it's not the end of the world. Your doctor will definitely help you come up with a clear management plan on how to live safely and normally with this new situation.

The main things to do are:

1. Strict Avoidance of allergenic foods:

• The doctor will give you a clear list of what foods are not good for you or your baby, and will also give you a good understanding of what foods may contain hidden ingredients.
• You should get into the habit of reading the food labels on every food package or bottle you buy from the store very carefully. Because sometimes foods we don't even think about, for example, sauces, soups, and biscuits, may contain those allergenic foods (e.g., milk, eggs, soy, peanuts , wheat).
• If your baby is going to school, it is very important to inform the class teacher, cafeteria staff, etc. about this. Also, when going to relatives' houses, friends' houses, or parties, informing others about this in advance can avoid a lot of unnecessary problems.

2. Keeping emergency medicine handy:

• Some food allergies can be very severe. That means, as mentioned earlier, a severe, life-threatening reaction called "anaphylaxis" can occur, which can cause sudden difficulty breathing, a sudden drop in blood pressure, and loss of consciousness.
• If such an emergency occurs, use it immediately. Your doctor will prescribe you a special medicine. It is called "adrenaline" (Epinephrine) . This usually comes in a very easy-to-use pen-like device (Epinephrine auto-injector). Your doctor or nurse will train you thoroughly on how to use it.
• You should always keep this "Adrenaline" (Epinephrine) medicine with you, or with your baby, at all times. You should take it with you in your school bag, when you go out to play, when you go on a trip, wherever you go. It's like a life-saving device.
• Also, it is essential that you, your family members, and those who will be taking care of your baby, such as your baby's teachers, know exactly how to use this medicine in an emergency. The doctor will explain it to you thoroughly and provide training if necessary.

The most important take-home message from all of this is:

If you have even the slightest suspicion of a food allergy, don't just decide to cut out or start new foods at will. Be sure to see a qualified doctor, get proper advice, and get the proper tests done if necessary.

• Skin prick tests and blood tests that look for IgE antibodies are the main methods used to diagnose food allergies.
• A "positive" test result alone does not guarantee that someone has an allergy. A doctor will consider many factors, including symptoms, the patient's medical history, and family allergies, to make a final decision.
• Sometimes, especially if the results are unclear, an oral food challenge may be done to see if an allergy has disappeared. However, this should only be done under the direct supervision of a doctor and in a hospital setting.
• If a doctor confirms that you have an allergy, do not panic or be afraid, and follow the doctor's instructions exactly. The most important things are to completely avoid the foods that cause the allergy and to always keep an "adrenaline" (epinephrine) auto-injector nearby for emergency use.

If you have any further questions about this, don't hesitate to ask your family doctor or an allergist. They are there to give you the right guidance. Stay healthy!

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