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More commonly, allergists conduct food challenges to show that a food allergy has gone away. Food challenges are also done to introduce highly allergic foods to young children in the hopes that early introduction will prevent a food allergy from developing.
Food challenges provide more in-depth information than common allergy skin tests or blood tests. This can be helpful if your child tests positive for an allergy to a food that he or she has never consumed. It can also clarify results if your child’s tests show an allergy to a food that has not caused an allergic reaction in the past.
During a food challenge, your child will be asked to consume increasing doses of a food that is believed to cause an allergic reaction. If your child has a reaction during the food challenge, he or she will receive immediate treatment. The test usually lasts a few hours.
The allergy and asthma team at Riley at IU Health performs food challenges at the Riley Outpatient Center at Indiana University Health and Indiana University Health North Hospital. IU Health North Hospital recently expanded its services to allow eight food challenges per week. This offers a safe, controlled clinical environment for your child and family.
Avoid giving your child any antihistamine medicines the week before the food challenge. Many over-the-counter cold or cough medicines may contain antihistamines. Check labels carefully before giving these medicines to your child.
Asthma maintenance medicines may be taken the week before the challenge. If your child needs to use a rescue inhaler more frequently in the week prior to the challenge, you may need to call the doctor to reschedule the appointment.
If your child is sick, has a severe eczema flare-up/rash or is recovering from a recent asthma flare-up that occurred within the past two weeks, you will also need to call the allergist’s office to reschedule the food challenge for your child's safety. Allergic reactions may be more severe under these conditions.
Your child should not eat anything after midnight the night before the food challenge or after breakfast if the challenge is scheduled in the afternoon. During this time, you may give your child clear liquids like water, apple juice, iced tea, sports drinks, popsicles or Jell-O. If your child is breast-feeding, he or she may continue prior to the challenge.
Prior to the appointment, a member of your child’s care team at Riley at IU Health will contact you to let you know what challenge food you need to bring and how to prepare it.
The morning of the food challenge, bring in the challenge food and a “mixing food” as instructed by the staff, including the challenge food’s original container or packaging. The mixing food should be a food your child likes to eat, and the challenge food will be added to the mixing food. Depending on whether you child has other food allergies, these mixing foods can be pudding, grape juice, applesauce or yogurt.
Since only one challenge food can be tested at a time, do not bring food that contains any of your child’s other allergens. You should also bring clear liquids for your child to drink during the challenge as well as any toys or books he or she may need to stay entertained.
The food challenge will last a few hours. You may also want to bring a change of clothes in case of vomiting.
After you check in, you will need to sign a consent form for the food challenge. We will review the allergy history and perform an examination. When ready, we will give your child increasing doses of the food every 15 minutes while watching for any reactions. We will monitor your child for an additional hour after the last dose or for an additional two hours if there was a reaction.
If your child should experience a reaction to the food challenge, his or her care team will be on hand to provide immediate treatment. If a reaction occurs, this means your child should continue to avoid that food. If no reaction occurs, your child's allergy specialist will provide instructions on how to best introduce the food into your child’s diet.
Food challenges can be confusing for children because they are being asked to eat a food that they have been taught to avoid in the past. You can help by encouraging and comforting your child and explaining that the food challenge is a safe time and place to eat the challenge food.
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