Dread. Total dread. That is what best described the knot in my stomach when the allergist said she wanted blood work for my two-year-old son. He was diagnosed with a peanut allergy at 8 months old. Tree nut and dairy allergies quickly followed.
We had delayed the blood draw for as long as possible by having the first peanut IgE testing done via a blood poke, which the pediatrician was going to do anyway for a routine iron test.
This time, the blood work was needed for an annual review to see any changes with his allergies and to inform our next steps. And it would be the real thing.
Full disclosure, I’ve never been great with medical stuff. I
full on ugly cried delicately teared up when we got home from the doctor after my baby’s first round of vaccines. I hated watching him go through the initial shock of the poke.
In college, I went to donate blood with my boyfriend (now husband) and wound up eating cookies, drinking juice, and having them elevate my feet into the air because I saw another patient’s blood start streaming into the tube and began to pass out.
When I had to have my wisdom teeth out, the doctors had to go get my husband from the waiting room and have him sit with me for 20 minutes in an attempt to bring my blood pressure down to an acceptable level to begin the surgery.
Embarrassing, but I am what I am.
So yeah, I admit it, I’m awesome at medical stuff.
And when it’s my child’s turn to have a medical procedure, that takes my anxiety to a whole new level.
If you can relate to this, let’s be friends! And a few of you might be thinking, “That’s weird.”
That’s cool with me. We should still be friends. If you are good with all things medical, then I admire you. Teach me your ways!
It’s Tough When It’s Our Littles
However you approach this, the reality of having our little ones go in for a blood draw just hurts our mom hearts. I’d take all the blood work (and then some) to prevent them from having to go through it.
They are little and they don’t understand. It’s scary for them. It breaks my heart.
What I admire about all moms is how strong we can be when necessary. When it comes to our kids, we do put on our best brave face.
Sure, we might cry our eyes out later after they go to sleep, but in the moment we are their everything. They need us to be brave, to make it less scary, and to be their comfort. So we do.
Food allergy moms do this constantly in the face of hard decisions and while experiencing medically traumatic situations. These moms continue to push ahead with the ever present thought, “It’s about them, not me. If we have to do this, how can I make this better for them?”
And you, beloved momma, have now joined the ranks of these courageous, admirable, and selfless food allergy mothers.
I’d love to share with you what our experiences were like in order to give you a little more insight into what to expect before your appointment. I hope to offer some things I learned and would perhaps do differently. There are some things I did do that turned out to be really helpful for us during the blood draw.
We have gone in for blood work twice for our kids. One was just my son when he was two. The second was for both my daughter (18 months at the time) and my son (3 at the time) and we did their appointments at the same time.
For my son’s first blood work test at age 2, we had it done at the lab that our allergist recommended and went immediately after the allergy appointment. The benefit was we could get it over with and not have the appointment looming over our heads for days leading up to it.
The downside was it was a lot for my son ,and for us, to have both the allergy appointment and blood draw in one day. There is no right or wrong, only what works the best at that time for your family.
The Blood Draw
The nurses had my husband sit in a chair with my son. It had that foldable arm rest so you could stretch out an arm on it for the blood draw. They checked both my son’s arms to find the best vein.
The nurses tied a rubber elastic band above his elbow to help with the blood flow. Next, one nurse began the blood draw while the other nurse held my son’s arm as my husband simultaneously held onto my son.
There is no glamor in having a blood draw with young kids. I wish there was an easier way to do accomplish the task. My son cried and began to struggle while my husband held him still.
I stayed close to his face so he could see me and hear me sing songs in an attempt to reassure him it would be okay.
Well, they missed the vein.
Meaning we then had to do it all over again with the other arm. Every mama bear instinct in me wanted to explode. But it would not help. Nurses are amazing people and they followed their protocol without us having to advocate for it. At that particular clinic, on young kids, if they miss once, the rules state that they go get someone else, which they immediately did.
My husband held my son again and the new nurse was successful. We got it done. We calmed my son and got out of there.
I won’t sugarcoat it. It sucked.
My husband and I were both pretty wrecked by it. However, by the time we got home, my son was happily playing with his toys and being his normal two-year old self.
He moved on much faster than we did.
The Second Round
We had both our son and our daughter with us the second time we went in for blood work. It was located at a pediatric hospital outpatient lab and it was evident that they had a child friendly approach.
They had numerous kid activities available and the rooms were decorated to entertain children. Simply put, the lab was clearly designed to be kid focused.
They actually had an additional support person attend to help with distracting our two kids. She had light-up toys, PBS kids loaded onto an iPad, iPad games, etc. It was really helpful to have someone who was solely there to bring some fun for the kids.
We had a similar medical setup that we had had at the previous appointment. However, I was the one that sat in the chair and held my kids this time. One nurse held my child’s arm still on the table while the other nurse administered the blood draw.
Unfortunately, they also missed my son’s vein.
Having to do two pokes with a 3 year old is miserable. He would have done much better if we had accomplished it on the first try. We switched arms, and the nurses were successful on the second try.
My son was pretty upset. There were a lot of tears and yelling, “Momma!” It felt awful. He needed lots of snuggles and reassurance afterwards to calm down.
They were successful on the first try with my 18 month old daughter. My daughter’s response was different than my son’s reaction. She was straight up mad. She angrily attempted to tear off the bandage and when the nurses who had done the blood draw offered my daughter a sticker, she looked them right in the face and firmly said, “NO!”
If I’m honest, I was kind of proud. Apparently, at 18 months, she was already confident in sticking up for herself. To be fair to her, these were the people that had just poked her in the arm with a needle.
The kids were upset. My husband and I were shaken up. But we had a family hug and headed home to our surprise presents we had prepared for our children.
You Will Get Past It
If you’re reading this before your child’s first blood draw, you’re probably like, “Gee, thanks for writing this. I feel so much better.” I’m not trying to upset you.
My hope is to give you a realistic idea of what to expect by sharing with you exactly what happened.
You can see from our experience that sometimes the lab is setup for kids, sometimes it’s not. Sometimes they get the vein on the first try, sometimes they don’t. Sometimes kids are really upset, other times it’s no big deal for them.
What I want you to know is, regardless, you will get through it. The appointment will be behind you before you know it. Although it wasn’t fun, we did get through it and our kids did bounce back quickly.
Overall, it was a very small part of their day, and in the grand scheme of things, a very small part of their life.
A Few Tips We Learned for the Appointment
We learned a couple of things from both of our experiences that may be helpful to your family.
1. Clarify the Protocol BEFORE the Blood Work Begins
Ask the nurses before the blood draw begins what the protocol is if they miss the vein so that everyone is on the same page before the blood work begins.
Personally, I want to know what their protocol is so that if I differ from it, I can advocate before we are put in that senerio.
For example, at some clinics, their protocol is 3 pokes before they stop. I personally am not comfortable with that many attempts in one day for my kids at this current age.
Right or wrong, good or bad, it’s past my personal threshold. Based on what my husband and I know about our kids at this season in their life, two pokes is our household max when they are toddlers and this little.
We would rather come back another time. Other families would disagree and would rather do the 3 pokes than have to come back. That’s great too. Maybe you aren’t comfortable with more than 1 attempt.
There is no “right” way to do this.
I am pro whatever you know is best for your kid. However, think through all these things before you get to the appointment so you can have your line in the sand. Get clarification on the protocol before the blood draw begins.
I am not trying to freak you out. More than likely, they will be successful on the first attempt. We have just had bad luck.
But I don’t want you to be caught off guard in the event that they do miss the vein. Have a plan and clarify the protocol first.
2. Have Distractions
It was really helpful to have brought a few things that our kids enjoy to help get us through the appointment. The appointment wasn’t just the blood draw. You have to wait in the lobby, then wait in the patient room before the nurses finally arrive.
It is great to have enjoyable distractions to get you through the waiting part of the appointment.
A few ideas for distractions:
- a couple toys
- tablet/iPad with downloaded favorite shows (so you don’t have to rely on wifi)
- sensory items (soft mittens/velcro/pop-its/spinners/sand hourglass)
For the blood draw itself, it was helpful to have those toys, shows, or books so that the kids had something to look at besides what the nurses were doing. One person definitely will need to help hold the child still. For both my kiddos, either my husband or I held them while the other distracted them with singing, talking, toys, etc.
The books and toys were also a nice way to help us move forward after the blood draw was over.
What helps your child feel at ease? A special stuffy or toy? A favorite book? Any of those can be helpful at this appointment.
3. Go to a Pediatric Facility
If this is an option for you, going to a pediatric lab can really make a difference. We have done blood draws for our kids in both pediatric and regular labs. The benefits of the pediatric ones are that, well, they are designed for your kiddo.
The staff are all trained for and are used to doing blood draws on young kiddos. Everything from the lobby to the patient rooms were designed with kids in mind (art on the walls, toys available, movies playing, etc.).
In our case, we were at an outpatient lab for the children’s hospital. They had a specific assistant who was there to help put the kids at ease. She came with a bag of toys and an iPad loaded with games and PBS kids videos.
If you do not have a pediatric lab available, which was the case for us on one of the blood draws, talk to your allergist or pediatrician and see if there is a lab that they recommend that would be better-suited for kids. That is what we did for my son’s first blood draw.
Our allergist referred us to a regular lab, but it was one that she referred little ones to on a regular basis and had received good feedback from the other parents.
Even if it’s not a pediatric lab, you can find awesome and experienced staff to help you through this. The staff was great with my son and we got through it
You will too, Momma.
4. Make Sure Your Child is Hydrated
Not a whole lot more to it other than this just helps everything to flow better. We have a fun water bottle to help our kids drink more water!
5. Have an Additional Adult Present
I recommend this for two reasons.
The first is for logistical purposes. At all of my kiddos’ blood draws, my husband or I had to physically sit in the chair and hold them still. If you are going alone with your kiddo, this is likely your role. We did find it beneficial to have another familiar adult be present so that they could talk, sing, and distract our children with toys.
If your child has a grandparent, or even a close family friend, that they feel comfortable with, it might be worth asking if they could attend the appointment with you.
On the other hand, you might have no choice but to go alone with your child. Please don’t worry if that is the case. The nurses can most likely accommodate you if you request an additional nurse be in the room.
The second reason I recommend having another adult is so that you have support. I’ve acknowledged that I’m not the best with medical stuff. It just bothers me and I usually feel pretty shaken up. Even when all my friends were watching Grey’s Anatomy and ER when we were in high school, I was the lone one watching Survivor because that’s all the medical and emotional drama I could take from my tv shows.
Some of you are strong with this stuff and I admire you. For those of you who, like me, will be nervous, it is nice to have another adult with you. Another adult can assist in asking questions, caring for your kiddo, and maybe even driving the car home for you.
6. Have a Strategy in Place to Make It a Positive Experience
The second time we had to do blood work, I really tried to think through what would make it a more positive experience for my kids. We ended up deciding to have a planned reward or fun activity for after the blood draw was completed.
Our kids were 18 months and 3 years old at the time, so we bought a couple small gifts. We wrapped them in secret and brought them out the morning of the appointment. We wanted the kids to see the gifts before leaving for the hospital.
It really wasn’t about the presents. The point was to be able to talk to our kids about something fun while at the appointment. “What do you think is inside? What could it be? We’re going to get a poke and then go home and open our presents. Should we play with our new gifts when we get home?”
It was a needed distraction.
Truly, being able to talk about the gifts at the appointment was a great and welcome distraction. As soon as the blood work was done, our 3 year old was like, “Do we get to go see what it is now!!!?” It really helped transition the kids (and us) out of the stress of the appointment. It was so nice to be able to come home, sit calmly on the floor, and play with some new toys.
The kids loved it, and in full honesty, it helped me move on from the appointment too. You could do this same concept in a variety of ways that would work best for your kids.
Here are a few ideas you could use as a reward:
- going to a playground
- watching a special movie or show
- going to a favorite store
- getting a safe treat afterwards
- having a special playdate
My kids both also love applesauce pouches so I made sure to have those waiting for us when we got back to the car.
You know your kids. What are the small things that could make this a little less scary and a little more positive for them?
7. Numbing Cream
This is something I am seriously considering for next year’s blood work. I learned from other food allergy moms that numbing cream is a possible option to help reduce the sting. It would be applied to the arm ahead of the blood work so that the child cannot feel the needle.
Given that the nurses have missed the vein on my son twice, I am seriously considering this for his future blood work. Having to do two pokes was highly stressful and distressing for my son and I’m not sure I’m comfortable doing that again.
Although I have not personally used the numbing cream option yet, my understanding is that it takes some advanced planning.
When I asked the nurses about this option for his future appointments, they let me know that it is a prescription cream and that we would need to get it prescribed by my son’s pediatrician.
We would have to pick up the cream and apply it ourselves ahead of the blood work appointment because it takes some time before it starts working (at least 30-40 minutes but that may depend on the specific cream). That would also mean we would need to wrap my son’s arm after application to keep the cream localized to that particular area.
It would take a little more planning, but it might be worth asking your allergist and/or pediatrician for the specifics on how they would want you to proceed if this is a good option for your child.
How to Prepare Your Kiddo
Another thing we changed for our second round of testing was talking with our kids about what would happen the morning of the appointment. The language we used was something like, “We’re going to go see the nurses today and have a poke.”
Our 3 year old didn’t like the concept of the “poke.” He instinctively knew he would not like it, but this way he wasn’t shocked by it when we got to the doctor. In fact, the doctors asked us if he was aware of what was going to happen, which is important at his age.
We were clear with our son that we would eat breakfast, go see the nurses to do a poke, and then come home and open an awesome gift!
The clarity of what to expect for the day took the surprise out of the experience for him. At three years old, our son was mature enough to ask lots of questions. We knew we needed to be honest about where we were going and what we were doing. The specific order of the day and outlining the steps was helpful to our son at that stage.
You know your kid better than anyone. Is there language you could use that would help? Is there a preparation activity that would be helpful for your kiddo? Or, maybe for your child, it would be best if they don’t know what will happen until they get there. You know what is best for you and your child.
Be clear on exactly why you are doing testing.
I am not a fan of testing for the sake of testing. I like to know exactly why we’re doing any testing, especially with my kids. Don’t be shy about asking the questions, “Why are we doing this? What is the purpose? How will the results change our current allergy plan?”
Given the very young ages of my kids at the time of both skin and blood testing, our current allergist was very encouraging that we do the least amount of pokes and testing as possible to get the information we need. This is one of the things I look for in our care providers.
For example, my son was due for an annual update on how his peanut, tree nut, and dairy allergies were progressing. Because the number of tree nuts that are needed to test is significant, and given his previous peanut numbers being substantially high, our allergist did not feel it advantageous to subject him to all of those skin pricks, especially when he felt they would likely continue to be positive.
We needed to do blood testing anyway for other allergy needs, therefore our allergist forwent the skin testing and just did bloodwork.
Last summer, based on prior testing and a successful partial-baked milk challenge, we suspected our son was outgrowing his dairy allergy, so our allergist wanted to see both a negative skin test and blood test. Then we could decide if it was time to progress on raw dairy introduction.
The allergist first ordered a skin test for dairy, but no additional skin pokes for my son’s other allergens. Once the skin test showed a negative reaction for dairy, the allergist then proceeded with a blood work order. I share all of this with you to highlight that we were given a very clear reason for why the skin and blood testing needed to be conducted.
Balancing Testing Needs with the Child’s Experience
After we had the second round of blood work done where a vein was missed again, our allergist was compassionate (and frustrated) that my son has had such a negative experience, again. He decided that our future plan would include a visit to the allergist within the year and zero testing.
Our allergist wanted our son to have a positive experience meeting with him. Instead of ordering more blood work testing for peanuts and tree nuts, our allergist extended my son’s next appointment to 18 months to give my son a break.
My Daughter’s Experience
For my daughter, our allergist only required blood work. She has a diagnosed skin condition that makes her skin highly reactive, (lots of histamine in her skin) which can impact skin-testing accuracy.
Especially given that one of the allergens we needed to test for (suspected reaction to sunflower) wasn’t available for skin testing at that clinic, she would need to do blood work anyways. Therefore, he only required blood work for the allergens he needed to test. It prevented her from having to do both types of tests.
Personally, I greatly appreciated the care that was given to both my children’s experiences. My philosophy is to do the minimum testing that is required to get the information needed to reduce stress on my kids. I encourage you to find an allergist that also advocates for the experience of the child and family concerning food allergies.
Research and data is SO important, and finding an allergist who is literate on all of that is key. But there is ALSO a care component that is vital. There is a stress that comes with living with food allergies, so having an allergist that is attuned to the kids and their experience has been immensely helpful to our family.
Understanding the Results
The blood work typically takes 2-5 days to get the results because it needs to be processed in a lab. The tests measure the presence of what are called IgE antibody levels to the specific allergen. These antibodies are what cause the allergy symptoms. If there are enough of these IgE antibodies in the blood sample, the result will indicate positive for an allergy.
Just like all medical tests, allergy testing does have limitations. Here are the main issues.
Typically, most allergy parents are told that 50-60% of blood and skin tests can result in false positives. This means that the test indicates a positive for an allergen when the person can actually tolerate the food. FARE is the trusted source of information about food allergies and explains more about false positives in this article.
Ability to Predict Severity
Another limitation of the blood testing is the ability to predict the severity of the allergy. For example, higher IgE levels on a blood test are not a guarantee of a more severe reaction like anaphylaxis.
Despite Limitations, Tests Are Still Very Useful
Testing is one of the data points that an allergist can use to make the appropriate recommendations for your child.
For instance, the test results in combination with reaction history and a child’s medical profile can give an allergist a clearer picture of what is going on with your child and what they need moving forward. For example, a reaction history combined with a positive skin test and a positive blood test tell a compelling medical story of what is happening inside your child’s body.
A Word of Caution:
If you are in food allergy groups on Facebook, you have likely seen some information about food allergy testing as well. Things like, the testing isn’t accurate, don’t avoid foods unless your child has eaten it and had a reaction, etc.
I will say this: your allergist is medically trained. The moms on Facebook are not, even if they are sending you informative articles.
If you feel your allergist’s recommendations are inaccurate or not the best for your child, getting a second opinion from a different allergist is definitely an option!
A lot goes into these tests.
Whether or not your allergist will recommend that you have your child avoid a food or not is based on a variety of information. They may want tests prior to different food introductions. There could be different foods they prioritize for introduction, etc.
This will not look the same for every food allergic child because each child has unique needs and a different profile.
So although you will see people in these online groups sharing lots of advice, articles, etc., do your own research, work closely with your allergist, ask lots of questions, and don’t underestimate the power of your own momma instincts.
Blood testing is a tool that can be very useful to inform the next steps for your child. I learn as much as I can from those online groups so that I can ask the questions that I need to and advocate for my children. But I lean heavily upon my allergist to guide us with the medical steps necessary for my kids.
I Know this is Tough
If your allergist has recommended blood work for your kiddo and your momma heart hurts a bit, I really, truly, understand. I want to encourage you by affirming that it is tough, but maybe you’ll get good news.
That is the hope of blood work testing. Maybe this time, the news will be that the allergy is getting better. I hold onto that hope closely while we drive to each appointment.
Or you may receive bad news. But you will also get more information to help you provide the absolute best care for the child you love so very much. I have received both results.
I hope that there were a few things in here that were helpful to you. My goal is to be that mom-friend who’s kids also have allergies. I get it. I really do. You are not alone.
Good luck at the appointment, Momma. You got this.