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Food-specific immunoglobulin G (IgG) testing is being increasingly used in children to diagnose food allergy and intolerance with often positive results for multiple foods.1 Although this enables children to avoid certain food items, there are often no appreciable benefits. The corollary is that patients may eat a food to which they have a true allergy because the IgG test was negative. It could be argued that avoiding foods to which children are not truly allergic does no harm as long as nutrition is sustained. It is, however, now increasingly accepted that there is nothing to gain in preventing allergies by delaying the introduction of solid foods to infants.2 On the contrary, early introduction of solid foods while still breastfeeding might induce tolerance and lower a child’s subsequent risk of developing atopic disease.3,4 Thus unnecessary avoidance of foods in early life may promote the loss of tolerance and facilitate onset of allergic disease. In light of this development and the recent experience of a patient who almost died because of misdiagnosis, we feel compelled to remind readers of the published guidelines on IgG testing.5-7

Immunoglobulin G testing in the diagnosis of food allergy and intolerance