Children's allergy

Meet the team

Consultants

Professor Adnan Custovic, professor of allergy
Dr Leanne Goh, clinical lead for paediatric allergy
Dr Claudia Gore, clinical lead for adolescent allergy
Dr Sharon Hall
Dr Erika Harnik
Dr Helen Cox
Dr Marta Vazquez-Ortiz
Dr Robert Boyle
Dr Paul Turner

Network consultants who work regularly with the team:
Dr Abbas Khakoo, consultant paediatrician, special interest in allergy 
Dr Umsunthar Thisanayagam, consultant paediatrician, special interest in allergy
Dr Ian Pollock, consultant paediatrician, special interest in allergy 

Specialist registrars

Dr Daniela Santoro
Dr Chiara Zuiani
Dr Parisut Kimkool

Dieticians

Justine Dempsey
Karen Wright
Samantha Blamires

Nurses

Rachel Griffin, lead clinical nurse specialist
Bethan Almeida, allergy and asthma nurse specialist
Ferdinand Morales, allergy and immunotherapy nurse specialist
Sabrina Lewis, allergy nurse specialist
Isabella Victor, allergy nurse specialist
Joanna Croft, paediatric allergy clinical nurse specialist
Lucy Underhill, paediatric allergy clinical nurse specialist
Gemma Kuru, paediatric allergy nurse

What to expect when you come to your appointment

Before your appointment

As a parent or guardian, you should attend all appointments with your child if they are under the age of 16.

Any anti-histamine medicines should be stopped for at least five days before attending the clinic to enable us to perform accurate skin tests. We ask that you take photographs of any visible symptoms such as skin rashes and bring the photos to your child's appointment, as this will help us make a diagnosis. 

If food is suspected as a cause, bringing the specific foods will also help us in testing. This should include any food packaging that lists ingredients. You should also bring a sample of any other materials or products you suspect may have caused a reaction (i.e. goggles, toys, cosmetics, jewellery etc.). 

Please bring all medicines and creams that have been prescribed and your child’s ‘red book’.

Check your appointment letter for anything specific you may have been asked to bring. In general it would be helpful if you could bring the following:

• your full address and telephone number(s)
• your appointment card and/or appointment letter
• your GP’s name and address

During your appointment

Children will usually see a number of professionals on the same day and will have allergy skin testing if appropriate or required. Therefore, the total time of the appointment can be two to three hours in some cases.

Please note that we are a teaching hospital, so medical students may be present for some appointments. If you do not wish to have them in the room please let the nurse or doctor know and the students will be asked to step outside.

The appointment will involve a doctor taking a detailed history of symptoms and the likely triggers. Details of similar problems affecting family members and of the home environment will also be requested.

A doctor or nurse will likely perform a test during the appointment. Tests may include: 

• Allergy skin tests: Normally children will undergo allergy skin tests. If skin tests are not possible or give confusing results a blood allergy test may also be required
• Food challenges: As part of our allergy service, we perform food challenges in a safe environment with highly trained and experienced staff. A food challenge is the most accurate way to diagnose a food allergy. During the test patients are given the food to which it is suspected they are allergic in gradually increasing amounts to see how they react. Many young children grow out of allergies and we use food challenges to assess if a previously diagnosed allergy can be ruled out in older children to improve their quality of life
• Lung function tests: Children with asthma will be asked to perform lung function tests, which involve blowing as hard and as long as possible through a tube. We try to make this enjoyable for children by using computer images, such as bursting balloons or playing skittles

Other tests and investigations include:

• blood tests
• full immunodeficiency testing
• exhaled nitric oxide (eNO) measurement test for allergic asthma
• state-of-the-art polysomnography to monitor breathing patterns during sleep

After your appointment

Following tests, advice will be given on avoidance of allergy-provoking factors. In the case of food allergies this will involve our allergy specialist dietitian. If medications are required an action plan will be provided and we will provide training on how to use devices such as inhalers and adrenaline auto-injectors for severe allergic reactions.

Videos for patients

Share this video with your child to help them learn what to expect during an allergy skin test. 

This video will help your child learn what they can expect during a lung function test.

Patient information leaflets

• Dietary advice for cow’s milk allergic children who tolerate baked milk
• Dietary advice for egg allergic children who tolerate baked egg
• Drug challenge - what you need to know
• Food challenge - what you need to know
• Following your inconclusive food challenge/supervised feed
• Following your successful drug challenge
• Following your successful food challenge/supervised feed
• Following your unsuccessful drug challenge
• Following your unsuccessful food challenge/supervised feed
• Soya ladder
• Supervised feed - what you need to know
• Wheat ladder

Refer to this service

GP

Please use NHS e-Referrals to refer a patient to our service.

Referrals to our paediatric allergy service should be made if a patient shows any of the following:

• faltering growth in combination with any other gastrointestinal symptom suggestive of food allergy
• no improvement in symptoms in response to a single elimination diet
• one or more acute systemic reactions suggestive of anaphylaxis
• one or more severe delayed reaction
• acute food allergies and asthma
• asthma not responding to moderate doses of inhaled steroids
• significant eczema where multiple food allergies are suspected
• persistent parental suspicion of food allergy especially in children with difficult or perplexing symptoms
• hayfever or rhinoconjunctivitis which doesn’t respond to first line medications such as non-sedating antihistamines and nasal corticosteroids
• suspected allergy to a medicine or anaesthetic agent
• systemic allergic reaction to an insect sting, e.g. wasp or bee
• chronic idiopathic urticaria or physical urticaria which doesn’t respond to treatment with non-sedating antihistamine
• typical symptoms of acute food allergy develop <1 hour after exposure, and include the development of urticarial and/or angioedema, breathing difficulties, vomiting, abdominal pain, diarrhoea or cardiovascular collapse after ingestion of allergenic foodstuff
• GPs should recognise that not all anaphylaxis is associated with rash.

When referring please ensure you tell us if the patient also suffers from asthma, hay fever or eczema and provide details of any food reactions or drug allergies.

Please also provide a list of all medications and creams prescribed.

If food is suspected as a cause, please ask patients to bring the specific foods to their hospital appointment as this will also help in testing. This should include any food packaging that lists ingredients.

GP advice

If you have questions about a patient or a referral, please call 020 3312 6650.