A very interesting article in the Wall Street Journal yesterday describes the difficulties of accurately diagnosing and treating food allergies. Essentially, modern allergy testing still can have issues with false positives and false negatives, making interpretation of these test results difficult. Ultimately, what happens in the "real world" is what counts. If your child has a reaction that is concerning for a serious allergic reaction, we will typically refer you to a board-certified pediatric allergist for appropriate management. They are trained and equipped to decipher your child's symptoms, consider diagnostics such as blood tests or skin tests, and then discuss what the results mean for you. On one hand, we do not want to eliminate certain categories of foods if no true allergy exists -- it is hard enough to get our kids to eat a well-balanced diet! On the other hand, it is still felt that the best way to "outgrow" food allergies is strict avoidance. It is also possible to do a supervised "food challenge," under close observation by an allergist, to reintroduce foods that were previously felt to be allergenic. Oral allergy immunotherapy is another exciting new technique -- basically, the child is given gradually increasing amounts of the offending food in order to develop tolerance. Again, it is vitally important to consider the risks and benefits of this for your child with an experienced allergist. There is also a great deal of fascinating information coming out about the prevention of food allergies and the ideal timing for introduction of foods in the first few years of life, so look out for new findings in the future.