update on milk allergy - astronaut ice cream

[suevv]

Hi all,

So a teacher at my son's preschool carefully read the ingredients - including milk solids, nonfat milk and whey - and somehow decided that Astronaut Ice Cream (freeze dried ice cream) qualified as "baked dairy."  Well, let's just move on from that analysis.

Fortunately, he ate a whole package of the stuff with no reaction.  My allergist now wants to skin test him.  My question is this - at this point wouldn't a positive scratch test just be a likely false positive?  Am I missing something here?  Why wouldn't a food challenge be the next step?

I just don't want to do a "poke" that won't yield useful info.

Thanks for your thoughts,
Sue 

[maeve]

You could always as for a RAST in addition to the SPT.  In think RAST testing is often done before a determination on whether to challenge.  At least with my DD at Hopkins the decision to challenge was based on her RAST score.

[CMdeux]

Honestly, I'm not sure what value either thing has, in light of the reason.

Why not just jump to a challenge?  It seems like your DS has already done an informal, unblinded one, albeit without your consent or knowledge beforehand, yes?

Lyophilization most definitely shouldn't impact the allergenicity of the protein, fwiw.  If anything, it's about as concentrated as it gets, given that all of the water is gone.   


(Congratulations, by the way-- I think your kiddo just outgrew...    )

[lakeswimr]

Lucky mistake.  I agree with CM. 

[YouKnowWho]

DS1 has positive RAST and SPT to numerous foods (rice, oats, corn, milk, soy, peanuts and tree nuts) but only has a handful of true allergens.

DS2 has negative RAST and SPT to numerous foods but has several true allergens.

We like to confuse the hell out of allergists

I would talk to your allergist about doing a food challenge without tests. 

[joanna5]

I'll skip over the holy-freaking-scary bit and jump to wow- that is really, really promising!  I'd definitely look for a challenge instead of testing.  Good luck!

[TwoDDs]

One more for straight to challenge - or not.  Depending on how much he ate, my doc. might just call this a passed challenge.

[suevv]

Thanks all for the thoughts.  "Holy-freaking-scary" indeed.  I had a little constructive chat with them.  They were very good about it, and I think appreciative of the teaching.  And they did get the point of how lucky they were....  [[FYI - for those who recall our preschool troubles at the end of last year - this is his new school and they are learning the ropes]]

Thanks especially for the technical input CMDeux.  I had been puzzling over whether the freeze-drying process could alter the proteins at all, but couldn't come up with anything.

Will keep you guys posted re allergist's response.  I'm going to ask for a challenge.  [[I'm ridiculously scared of this, though.]]  Wish we had a "fingers crossed" emoticon.

Sue

[CMdeux]

WE do--

two, in fact.  Which I think is highly appropriate under the circumstances!

      and       

[AllergyMum]

The first part terrifies me, and I am so glad that your child did not need an epi.  Boot to the head to that teacher for feeding your child anything

For me I would ask for an in-office challenge.  My son has had 4 in-office challenges, and they have all been so scary to me, but sooooooo worth it when they have shown him outgrowing an allergy.  Fingers crossed that your child has outgrown