Oral Food Challenge

What is an oral food challenge?

An oral food challenge is a validated (proven) form of allergy testing used by allergy specialists to help determine if a food allergy exists or not. Oral food challenges are carried out to help your allergy specialist to:

  • Confirm a suspected food allergy (where allergy tests are not clear)
  • Monitor if a food allergy has been outgrown
  • Confirm or not a food allergy following a positive allergy test where the person has never eaten that food.
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Where are oral food challenges carried out?

  • Oral food challenges are always carried out in a safe environment (hospital or allergy clinic).
  • Oral food challenges are carried out under the supervision of allergy nurses and/or doctors who have the knowledge and skills to recognise and respond to the signs and symptoms of an allergic reaction.
  • Oral food challenges are carried out in settings where there is access to allergy medication and medical equipment to treat an allergic reaction.

What happens during an oral food challenge?

You will attend a hospital/clinic where an allergy nurse/doctor will check and record your vital signs (blood pressure, heart rate, temperature). Oral food challenges are often carried out
in an open plan setting with other children or adults attending oral food challenge/ allergy appointments.

At the start of the oral food challenge you will be given a very small and measured amount of the food. Once this first dose has been given you/your child will be closely observed. The allergy nurse/doctor will be closely observing you for signs of an allergic reaction, for example a rash or swelling. It is very important that you tell them if you are experiencing any symptoms that they may not be able to see, for example itching or tingling.

In oral food challenges for infants and children they will be fed and encouraged in an age appropriate way.

It is very normal for anyone having an oral food challenge to have questions and concerns and the nurse or doctor will be able to answer these and give reassurance. If you have thought of some questions before the appointment it may be useful to write them down to take with you. Discuss any concerns or anxieties with the Nurse or Doctor at your appointment. They should be able to answer any questions you have.

How long does an oral food challenge take?

The amount of time you will spend at your food challenge appointment will depend on many factors, including the schedule for the food with which you are being challenged and the staff and resources available. Expect to be at the hospital/clinic for several hours and make provision for any commitments you may have later in the day to be taken care of as food challenge appointments may often run over their scheduled time.

What do I need to do?

It is important to be well on the day of the oral food challenge. Even minor conditions such as a cold, cough or high temperature will mean that the oral food challenge will not be carried out on that day. If you are unsure, call the allergy department for further advice.

Asthma should be well controlled. However, if asthma has been a problem either on the day of the appointment or in the days leading up to the appointment the oral food challenge will not be carried out and will need to be re-scheduled.

What might I need to bring to my food challenge appointment?

The hospital/clinic allergy department may provide the food to be trialled on the day. If they cannot provide the food you may be asked to bring it with you.

It is important to take to take all the allergy medication you would normally carry with you to the appointment. The hospital or clinic will have allergy medication to use if needed.

For children taking a change of clothes is advisable in case of any accidents, and spare nappies for infants.

Take something to read or occupy your time as you orgmay be in the hospital/clinic for several hours. If you are the parent of a child attending an appointment taking a special toy/comforter, as well as some distraction (toys/books etc.) is a good idea.

What happens if there is a reaction during an oral food challenge?

You or your child will be closely observed for any signs or symptoms of an allergic reaction during the oral food challenge.

If you develop signs and symptoms of an allergic reaction you will be treated appropriately for your individual symptoms. Depending on the symptoms, and whether the allergic reaction is mild, moderate or severe, remember that the treatment for allergic reactions in an allergy clinic/ hospital setting may be different to how you would manage an allergic reaction at home.