Finding a trusted allergist is essential to managing your child’s allergies. Knowing what to expect and what questions to ask during your appointment will get this all-important relationship started on the right foot.
First, come prepared to give details and a thorough history of the symptoms, says Clifford W. Bassett, MD, medical director of Allergy and Asthma Care of New York and assistant clinical professor of medicine at the NYU School of Medicine in New York City. Don’t rely on memory — write everything down.
Get Prepared for the Appointment
Here is some of what you may be asked:
What allergy symptoms does your child experience?
“Make a list of current allergy-related problems and symptoms, along with a timeline that includes onset, duration, level of severity, and what has actually helped the problem,” suggests Dr. Bassett.
Was the allergic reaction caused by a food?
If you suspect a food allergy, keep a daily food log and record any associated symptoms that occur after ingesting the culprit food. A food journal is a great place to begin when trying to determine whether an allergy is present, he says.
What treatments or medications have your used to try to relieve symptoms?
The allergist is going to want to know if you have had any success with over-the-counter or prescription medications. This can help guide the next step in treating the allergy.
Does anyone in your family have allergies?
“I query the family regarding any history of allergy in the immediate and extended family, such as asthma or nasal allergy,” Bassett says. “If family history and exam indicate possible allergy, the next step is skin testing and blood testing for allergies.”
Bring a List of Your Questions
Your appointment is the time to get answers to any questions you may have. Your list of questions might include:
What symptoms indicate an allergic reaction?
Each child will respond differently to allergens. Your child may develop an itchy rash or hives while another child could have a gastrointestinal response such as abdominal pain, gas, or vomiting. The most severe reaction is anaphylaxis, which can be life-threatening. An anaphylaxis response may begin with flushing, a rash, or hives and progress to shortness of breath, light-headedness, airway constriction, and a drop in blood pressure.
How will my child be tested for allergies?
Testing can be done in several ways, Bassett says. Blood and skin tests are most common. “The majority of children will undergo a skin prick test — virtually painless and performed on the arm,” he explains. “Skin prick testing can be performed in less than a minute and allows us to determine if allergic sensitization has occurred to foods or other allergens, enabling a diagnosis of a specific allergy.” Testing can often be done in one visit, and the results appear within 15 to 20 minutes.
When should I treat my child’s allergies with an antihistamine?
Oral antihistamines can be helpful for relieving mild symptoms such as hives or rash. These medications can be taken daily to keep symptoms under control or as needed when symptoms appear. Your doctor will determine the best course of action for your child’s specific symptoms.
When should I use epinephrine?
Your doctor will provide guidelines for the use of epinephrine if your child’s allergy puts her at risk for a severe allergic reaction. Signs of anaphylaxis include wheezing, chest tightness, fainting, weak pulse, tightness in throat, drooling, swollen tongue, slurred speech, blueness around lips, vomiting two or more times, severe abdominal pain, or large hives. Always call 911 immediately after using epinephrine. Since the medicine wears off within a half hour of administration, the reaction may return and your child will need to be closely monitored.
When should I call your office and when should I call 911?
If the allergic reaction is mild, call your doctor for advice on how to treat the symptoms. If symptoms are more severe and warrant the use of epinephrine, call 911.
How do I know which foods contain culprit allergens?
If a food allergy is suspected or identified, ask your allergist for help decoding and understanding food labels. He or she can help identify common allergens that may have other names on labels. For example, “casein” is a milk protein you want to avoid with a dairy allergy. To help avoid exposure to culprit foods, your allergist can also help you to construct a food allergy action plan and a “chef card,” which is especially helpful when your child is away from home at a restaurant, camp, or school, Bassett says.