When Should You Actually Test Their Immune System?

Your child has been sick seven times since September.

You’re keeping a tally. You’ve used all your sick days. You’re starting to wonder if something is actually wrong.

Should you ask for immune testing?

Let’s walk through this.

What is “Immune Deficiency”?

Primary immunodeficiency disorders (PIDDs) are genetic conditions where the immune system doesn’t work properly.

How common are they?

Rare. About 1 in 1,200 people. Most are diagnosed in childhood.

Translation: If your child gets lots of colds, it’s probably not an immune deficiency. But if they meet certain criteria, testing might be warranted.

The “10 Warning Signs”

The Jeffrey Modell Foundation (experts in immune deficiency) lists 10 warning signs:

• 1. 4+ new ear infections in one year
• 2. 2+ serious sinus infections in one year
• 3. 2+ months on antibiotics with little effect
• 4. 2+ pneumonias in one year
• 5. Failure to gain weight or grow normally
• 6. Recurrent deep skin or organ abscesses
• 7. Persistent thrush or fungal infections
• 8. Need for IV antibiotics to clear infections
• 9. 2+ deep-seated infections (meningitis, sepsis, bone infection)
• 10. Family history of primary immunodeficiency

Notice what’s NOT on this list:

“Lots of colds.”

Normal vs. Concerning

✅ PROBABLY NORMAL

• 6 -12 colds per year
• 2-3 stomach bugs per year
• Occasional ear infections that respond to antibiotics
• Pink eye once or twice
• Hand-foot-mouth disease, croup, etc.

⚠️ POTENTIALLY CONCERNING

• Multiple pneumonias
• Recurrent sinus infections requiring antibiotics
• Ear infections that don’t respond to treatment
• Deep infections (blood, bone, organs)
• Chronic diarrhea + poor growth
• Unusual infections (fungal, atypical bacteria)

It’s the TYPE and SEVERITY of infections that matter, not just the frequency.

What Immune Testing Involves

If testing is warranted, we typically start with:

Complete Blood Count (CBC)

Checks overall white blood cell counts and types

Immunoglobulin Levels

Measures antibody levels (IgG, IgA, IgM, IgE)

Vaccine Response Testing

Checks if body made antibodies to vaccines they’ve received

More specialized testing (genetic testing, T-cell function, etc.) is done by immunology specialists if initial tests are concerning.

How We Help at Night Watch

When you bring your frequently-sick child to us:

• Review their illness history
• Diagnose current illness (strep, flu, ear infection, etc.)
• Evaluate patterns (are these serious infections or common colds?)
• Order initial testing if warranted (CBC, immunoglobulins)
• Refer to immunology specialists if testing suggests immune deficiency
• Reassure you when it’s normal childhood illness

📝 What to Track

Keep a log if you’re concerned:

• Date and type of each illness
• Whether antibiotics were needed
• How well they responded to treatment
• Any hospitalizations or ER visits
• Growth patterns (height/weight)

Bring this to your visit. It helps us see the big picture.

The Bottom Line

→ Most kids who get sick frequently have normal immune systems

→ 6 -12 illnesses per year is textbook normal for young children

→ It’s the severity and type of infections that matter, not just frequency

→ True immune deficiency is rare

→ If you meet warning criteria, testing is appropriate

🤧 Worried about recurrent illness? We can evaluate.

Most of the time, it’s normal. But we’ll help you know for sure.