Angie's LIST Guide to
Pediatric allergy and immunology

A pediatrician specializing in allergy and immunology cares for children who suffer any kind of allergic reaction. From food allergies to bee stings, the pediatric allergist treats a range of child allergies, offering comprehensive testing and treatment options.


pediatric allergist and immunology doctor meets with patient and her mom
Dr. Mark Holbreich, an Indianapolis allergist, meets with mom Mary Munson and 7-year-old patient Melaina before a skin allergy test. (Photo by Brandon Smith)

Expert care for your child's allergy

mom holds daughter during allergy skin test
A pediatric allergist specializes in making kids and parents comfortable during allergy testing. (Photo by Brandon Smith)

Pediatric allergy and immunology specialists are experts at working with kids who suffer from allergies. They treat everything from hay fever, sinusitis and asthma to rashes, hives, insect sting, food or drug allergies. They not only find the source of the allergy problem, but do so in a way that puts your child at ease during the examinations. A kid-centered office and staff may ease your child's anxiety and fear that often accompany a serious allergy. 

Pediatric allergists are trained in the latest diagnostic and treatment tools to effectively care for young patients. While many doctors treat into a patient's teen years, new therapies and safe tools for infants are also a part of this focused specialty.

The pediatric allergist will test your child to discover the irritant or other underlying cause of the reaction. Once the doctor identifies the problem, he or she can set up a treatment regimen to help restore the child's comfort and prevent any future allergy attacks.

Allergy specialists can educate families all about the child's allergy, which can include teaching them how to react quickly and effectively if their child accidentally comes in contact with an allergen. For food allergies, the doctor can also teach parents how to read food labels and prepare safe meals.

Doctors often ask about the child's home and sleeping arrangements, so they can offer suggestions on how to reduce possible allergy triggers that may cause an allergic reaction like dust mites or pet dander.

What pediatric allergists treat

Pediatric allergists and immunologists treat common problems in children such as hay fever, asthma, hives, recurring thrush and eczema.

These specialist doctors search for the irritant that triggers the physical reactions and manage the symptoms. Irritants that can create problems include airborne particles like dust, as well as insect stings and food allergies that can cause severe reactions, including anaphylaxis, a life-threatening allergic reaction that causes severe symptoms, such as difficulty breathing.

If you suspect a problem with a particular substance, start recording everything your child eats or encounters and any reactions. This history can help the allergist diagnose and treat your child more effectively.

For more information, check out the Angie's List series: What you should know about children and food allergies

Allergy testing procedures

Allergy tests help detect the substances causing an allergic reaction. The wide variety of allergy tests includes skin tests, elimination-type tests and blood tests.

allergy skin test results
Skin allergy testing exposes the child to small amounts of potential allergens to see which provoke an allergic reaction. (Photo by Brandon Smith)

Skin testing is the most common of the three and specifically identifies food allergies, causes of asthma, penicillin allergy or allergic contact dermatitis. An allergist can conduct a skin test using a few different methods.

One way is a prick test where a doctor places a small amount of the suspected allergen on the skin and then pricks the skin so the substance goes slightly under the surface. Alternatively, the doctor can inject a small amount into the skin or use the patch method to diagnose allergic reactions by taping allergens to the surface of the skin.

The elimination method checks for food allergies. The potential problem foods are eliminated from the diet for several weeks and then slowly reintroduced one at a time. The person, or family in the case of a young child, carefully watches for signs of an allergic reaction throughout the process.

Finally, the allergist can use blood tests to measure the antibodies for a specific allergen in the blood. Known as the radioallergosorbent (RAST) test, this method is used when skin testing isn't a good match for the child.

Child allergy treatments

Once the pediatric allergist diagnoses the child's triggers, he or she will prescribe appropriate treatment to get your kid feeling better and avoid future allergy attacks. There are a variety of allergy medicines, with decongestants and antihistamines being the most commonly prescribed, according to the American College of Allergy, Asthma & Immunology. Both help to reduce stuffy or runny noses, sneezing and itching.

Other medications work by preventing the release of chemicals in the child's body that cause an allergic reaction. Corticosteriods effectively treat inflammation in the nose. 

RELATED: How to get relief from seasonal allergies

Allergy shots offer a preventative treatment option. During allergy immunotherapy, the doctor delivers doses of the allergen, gradually increasing the amount in hopes the body will become less sensitive to the problem substance. The ACAAI says this allergy treatment is often used for grass pollen, dust mite and bee venom allergies.

Immunotherapy is also an effective treatment for allergic asthma. As there is a risk of anaphylactic shock, it's only recommended immunotherapy be performed under qualified medical supervision. 

Finding a good kid allergist

While a pediatrician can certainly help with issues like hay fever and is a good source when your child first encounters an allergy issue, a pediatric allergist or immunologist is specially trained and experienced in diagnosing and treating allergic diseases.

A board-certified pediatric allergist undergoes ongoing training and testing to maintain certification. They obtain at least three years of specialty training in pediatrics after medical school, and then complete two or more years focused on allergies. 

Search the Allergy & Immunology - Pediatrics category on Angie's List to find a highly rated doctor in your area and read what other parents have to say about their experience.

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