Oral Food Challenge – What to Expect

An oral challenge is a procedure completed in the Allergy, Asthma, and Immunology Clinic to determine whether your child reacts to a certain food. This procedure involves monitoring your child while they eat increasing amounts of the challenge food at regular time intervals.

Our care team will monitor your child closely for any symptoms of an allergic reaction to the food. They are also happy to answer any questions you may have prior to the challenge or during the day of the procedure.

One week before the oral food challenge

Stop all antihistamines for 7 days prior to the food challenge. Common antihistamines are:

• Cetirizine (Zyrtec)

• Diphenhydramine (Benadryl)

• Desloratadine (Clarinex)

• Fexofenadine (Allegra)

• Hydroxyzine (Atarax, Vistaril)

• Levocetirizine (Xyzal)

• Loratadine (Claritin)

Other medications, such as over the counter cough and cold medications, may be included in this list. If you are uncertain about a medication, please contact the Allergy clinic to verify.

Please continue asthma medications.

The day of the food challenge

This procedure is scheduled early in the morning and you should expect to be in the clinic for at least half the day. If your child has a reaction, the appointment may take longer.

Your child must be in good health the day of the oral food challenge appointment. If your child is ill or has any symptoms such as cough, wheezing, hives, vomiting, diarrhea, or others, please call the Allergy clinic to reschedule as the challenge will not be completed.

A small meal/breakfast is allowed the morning prior to the challenge up to two hours before your appointment time unless otherwise instructed. This meal should be something your child has previously eaten and tolerated regularly in the past.

Your child should not have anything to eat or drink except for water at least two hours prior to arriving at the clinic for the challenge.

The clinic room has limited space. We ask that only the parents/guardians be with the child during the food challenge.

Admission to the hospital, including transport by emergency services, may be necessary if your child has a severe reaction during the oral challenge.

What to bring

Please bring the following items with you to your appointment:

• Two unexpired epinephrine autoinjectors (such as Epipens, Auvi-Qs, Adrenaclicks, etc.)

• The food to be challenged, prepared as directed (i.e.: cow milk, soy milk, egg, peanut butter, etc.). Food can be refrigerated or microwaved in the clinic if needed.

• Change of clothing for your child and yourself (sometimes, vomiting occurs).

• Activities or movies to help pass the time. The clinic room will have a DVD player available.