In children with non-IgE mediated cow’s milk protein allergy, skin prick tests are often used to diagnose, despite the child showing clear symptoms.
Skin prick tests do not provide reliable results on a non-IgE mediated allergy to cow’s milk (or other foods). Here is why.
Skin prick tests give false negatives as well as false positives. That means they may show your child is allergic to a food (when they aren’t) and show they aren’t allergy to a food (when they are not).
Let me give you an example of a client of mine who had clear signs of a non-IgE allergy to cow’s milk protein from birth (diarrhoea, rash and vomiting), however, the mother of the child was not helped. She was told that nothing is wrong with her baby. She had gone to the health visitor 5 times and seen her GP 4 times before she went to get help privately. The private clinician provided a skin prick test which showed that the child was allergic to wheat (he wasn’t even weaned at this point) but not allergic to milk!
This mother became so desperate after days and months of sleepless nights and a crying baby. She contacted me on Instagram because she had seen a post of mine and we spoke online.
I immediate diagnosed the child with cow’s milk protein allergy and prescribed a cow’s milk free formula. After 3 days, the child’s symptoms had vanished.
There was no need to do a test, the symptoms were clear to me, the child has non-IgE mediated allergy. We re-introduced cow’s milk formula (small amounts) after 6 weeks of being cow’s milk free and the child reacted again so we stopped. This confirmed the diagnosis.
The body and it’s reaction is the best tools we can use…..
This is an example of the issue with an allergy test. Sometimes they show up as negative (though it actually is positive) or they may show up as positive when they are negative!
The child wasn’t even allergic to wheat! We introduced wheat at 7 months with no issue at all.
A skin prick test could potentially result in us labeling a child with an allergy when there is no clinical indicator of an allergy. We do not want to eliminate a food that doesn’t need to eliminate from the diet.
This is an example that the body and how it reacts to a certain food is our best indicator of a food allergy, not a skin prick test. An allergy test is a piece of a puzzle if you like. We must first consider clinical symptoms of the child, family history is also important and also we look for what happens when we eliminate and re-introduce that food back into their diet.
So if your child shows clear symptoms of an allergy to cow’s milk, what do you think the test will do for you?
I think tests are there to give us peace of mind, however, this is an illusion. Why can’t we trust the signals that the body shows us? Why do we have to use a test that isn’t even reliable!?
I am not saying don’t do it, Iam saying….let’s think…why put our children through more drama of having their skin pricked?
National and international guidelines clearly state that in children with a suspected non-IgE mediated allergy to cow’s milk should first have the milk excluded form their diet and then re-introduce to confirm the diagnose. This is for both the breastfed and formula fed infant.
Read about the diagnostic pathway for children with suspected cow’s milk protein allergy (iMAP Guidelines) and NICE Guidelines. Food allergy in under 19s: assessment and diagnosis.
The focus here is on non-IgE mediated allergy, not IgE mediated allergy.
For IgE mediated allergy, contact your doctor immediately.
Please note that this information neither is medical advice, nor is it meant to replace the advice of your doctor or dietitian and I assume no liability for the use or misuse of this information.