ALLERGY SHOCK
Parents test kids in hospital carparks as specialist wait lists grow
Parents are parking near hospitals and doctors’ offices before giving their children food to test for a serious allergic reaction. Allergy NZ says parents have carried out “food challenges” on their children in hospital carparks, because of growing wait lists with specialists. And the situation is particularly bad in the regions with families telling the Weekend Herald it can take up to a year after a referral from a GP.
Families have told of GPs advising the best option is to test foods when near a hospital. But Allergy NZ chief executive Mark Dixon said that could feel like “Russian roulette” to parents with children who had severe allergies. The safest place for food challenges was in hospital, not carparks.
“People are being asked to take risks because of capacity issues.”
Food allergy reactions include eczema, nausea and vomiting and lifethreatening anaphylaxis, which sends the body into shock.
Children can grow out of some allergies, but others persist.
A food challenge or feeding test can reveal if allergen sensitivity has changed or gone away. At hospital, an experienced nurse gives increasing amounts of a food over about six hours. Most reactions resolve without treatment, or with antihistamines. If skin and blood tests indicate a reaction is unlikely, specialists can advise that some foods be trialled at home.
Auckland DHB staff were aware some parents were giving their child new foods while near the hospital. Dr Mike Shepherd, Starship child health director for medical and community, said parents worried about introducing new foods at home should first talk to their GP.
A North Island woman, who asked not to be named, said her daughter’s doctor advised her to consider testing food near a hospital. Her 10-year-old has had severe allergies,
including to peanuts. Hospital tests had shown she was not allergic to some nuts. However, her GP indicated more tests were unlikely.
“[Her GP] suggested if I wanted to try any of the other nuts for her, to go and sit in the hospital carpark and do it. This isn’t a reflection on him . . . it’s just the state of the system.”
Kylie, who asked for her surname to be withheld, regularly parked near Auckland City Hospital to give her daughter tiny amounts of peanut butter as a baby. Her 3-month-old had severe eczema, which was eventually traced to a nut allergy.
A private specialist mapped out two years of gradual exposures that lessened some allergies. That involved small exposure to about 10 foods, deemed safe enough to try at home. Food challenges to check progress were done at hospital.
Nervous, Kylie did the weekly peanut butter exposures near hospital, sometimes in the carpark, sometimes on a bench.
“You have an action plan that points out the worst-case scenario symptoms — hives, itchy throat, shortness of breath. If any of those signs happen you would do [an adrenaline shot].”
After one she ran inside with her daughter, now 5.
“I was being probably a bit overdramatic, but it’s quite hard to know if they are having an attack . . .”
Christchurch teacher Bex Roberts is severely allergic to peanuts and fish, and her daughter is allergic to kiwifruit, with a risk of anaphylaxis. Four years ago and before her two children started school, Roberts wanted to know if they shared her allergies.
However, her GP couldn’t supervise food challenges, and said they wouldn’t get in at the hospital as there wasn’t evidence they had
allergies. Roberts’ husband took the children, 2 and 4, to a bench near the hospital and gave them peanutbutter sandwiches. Fortunately, they weren’t allergic.
“The doctor basically said, ‘You are better to be right near the hospital where people do breathing tubes for young people all the time’. With anaphylaxis, kids can go downhill so quickly. I understand why my doctor didn’t want to take that on.”
The Ministry of Health and New Zealand Medical Association (NZMA) were unaware of food challenges or trials done outside hospitals or doctors’ clinics.
A ministry spokesman said food allergies were common and referrals to paediatric services could be high and services needed to rank them according to seriousness and balance them against the resources that were available.
Hospitals, including Starship, aimed to increase food challenges over summer when there were fewer unwell children, the ministry spokesman said.
“Food challenges for infants and children where home introduction of a food would be advised but parents prefer a hospital-supervised challenge are often triaged to this category of ‘summer catch-up’, or are offered a cancellation slot as they become available.”
Dr Jan White, NZMA chairwoman of the General Practitioner Council, said parents should see their doctor before taking any action.