6 month baby allergy test: scratch vs blood draw
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Anonymous
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My 6 month old baby seems to be allergic to peanuts and possibly other foods. He needs either a scratch test or blood test. The blood draw is faster and more conclusive for nuts, which is our main concern. But I hate the idea of my baby in pain from a venipuncture.
If anyone has experience with either of these allergy tests on a baby, I’d appreciate hearing your thoughts. Is the scratch test very uncomfortable? I am also concerned about how long the scratch test will take because his wake window is only 2 hours. Just getting him to the doctor will take 40 minutes, so even if he wakes from his nap just in time to leave, he may melt down before the testing is done. |
Anonymous
OP- he is going to melt down anyways and usually they do both. A scratch test is multiple pokes/scratches with a needle in their back, it takes sometime to complete and then its waiting for reaction. And they arent allowed to move around, cant touch the pokes, etc. If you nurse, just nurse him through. Try to have someone with you. It was stressful and hot in our room and its just a lot. Couple of things for the venipuncture- make sure you have someone who is well versed in pediatric draws, make sure your baby is warm and hydrated. Dont let office staff try more than two times. If they cant get it, they cant get it and honestly with how much my kid was crying (annoyed and overtired) there was no way he was hydrated. We have had much better luck with LabCorp compared to office staff. |
Anonymous
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We did both on our 12 month old. The blood test showed slightly allergic to one of the peanut proteins but the skin test showed a huge reaction.
Went on OIT and was desensitized by 2 year old. Now she eats pb&j every other day. Also if note - the blood test showed a reaction to sesame but the scratch test showed none. So we went on to a food challenge and passed. I would definitely consider doing both blood and scratch test |
Anonymous
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My son’s allergist had us start with a scratch test after he had an allergic reaction to egg. After a year, he had blood drawn to see if his IgE levels had dropped low enough for him to qualify for an exposure test.
DS was 1yo at the time of his scratch test. I kept him distracted with some toys while the nurse did the testing. He didn’t even notice! I don’t recall how long it took, but it was much shorter than 2 hours. |
Anonymous
| I have had both kinds of testing done on a 6 month old and a 9 month old. I think it's easier when they are younger. Just nurse or bottle feed him. For the scratch test, he will sit on your lap facing you, FYI. Do both tests. |
Anonymous
| Do both tests. But agree with everything the prior poster said about hydration and warmth, and a good phlebotomist. We had a labcorp tech do a venous draw on our 18 month old, and hydrated, distracted by a bluey video, and armed with a lollipop she truly did not notice the stick until it was time to choose a bandaid. I will never take my daughter anywhere else for bloodwork. |
Anonymous
| The blood draw at that age is absolutely nothing. Mine did not even notice or cry. She did cry (though not much at all) when she has it at age 2. The younger the better, I promise. We had both tests done. You need both. |
Anonymous
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I had my 6 mo old’s blood drawn at JHH— legit she didn’t even flinch. Seriously, their phlebotomists are miracle workers (one toddler cried briefly with the other woman, another infant also didn’t cry)
The scratch test is unpleasant for longer, my kiddo was super itchy and cranky. And you have to avoid any antihistamines ahead of time too. The blood test is also more quantitative, and less likely to be “false” positive. My kiddo was pan positive on the skin test but also gets angry (not quite dermatographia) welts from any scratch. Good luck. |
Anonymous
Where did you do OIT? Did you have a threshold for IgE before starting OIT? I’m eager to do OIt (cashew) for my 12 mo old but our team at JHH wants to wait. |
Anonymous
| Blood. One of the allergists we saw contaminated the scratch test by reusing the scratcher. Peanut lit u0 everything after it. So dumb. |
Anonymous
| I believe you are supposed to do both. The blood draw advice here is good- have baby hydrated, go to someone that is used to drawing from babies. Scratch test will be annoying for the baby but not too bad and it should all be over with witching 15-30 minutes. |
Anonymous
We did it in Mclean - Mclean allergy and asthma. They had just developed a peanut OIT for young toddlers using bamba. I am not sure about cashew though |
Anonymous
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OP here. Thanks for the advice everyone, especially about how to have a successful blood draw.
PPs who said to do both tests- what is the reason for that? I thought that if I do one test and everything is negative we do not need to do the other. |
Anonymous
| The scratch test is very prolonged and can be inconclusive. I’d rather just get it done in one puncture via blood draw |
Anonymous
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we did both- at 6 months- started with scratch test, then follow up blood test for the 3 that were positive... and then oral food challenges for those. mine was positive on skin and blood but passed oral food challenges. the scratch test was the easiest of the three (perhaps because my husband was there to hold her still while i was alone for the blood draw and she had just started self weaning so my attempt to nurse for comfort failed..). the oral food challenges were in some ways the hardest as they were 3 hours which was well beyond her wake window and you're forced to keep them awake and keep feeding (which she really didn't want to eat at that point, in part because of skin reaction, and part because she was irritable and tired so e didn't finish final dose which made it feel even more inconclusive!).
highly recommend burcin fraser. |