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How does a food challenge work...?

(18 Posts)
mummynoseynora Thu 28-Jul-11 21:40:01

Hi all

hoping the collective wisdom of mumsnet can help here!

A while back (jan) I posted about DS and a possible strawberry allergy. He had his first appt at the hospital in may - pinprick testing (negative) followed by a blood test (negative!) The nurse was pretty convinced of the allergy from the history (two incidents , one projectile vomitting for about 3 hours, the other a full body rash - worse at hands and mouth) so took the case to her consultants meeting
she was advised that basically strawberry allergies are a bugger to diagnose, and often their vials of strawberry 'stuff' are useless as the allergens are unstable or something (got lost)

there was also mention of possible oral allergy syndrome so we were advised to also keep him off blackberrys and raspberries until new tests

so - tomorrow I am off to the hospital for a food challenge... we have to be there at 8am and take some fresh strawberries... that is ALL I know....

can anyone give me an idea of what will happen? (apart from obviously somehow making him eat strawberries) and how long we might be there, I figured it will be a while as he's booked onto a day ward!

mawbroon Thu 28-Jul-11 21:57:07

I can tell you what happened when ds1 did a food challenge for egg, but it may well be different because the egg is done in stages, starting with egg as an ingredient on the first visit, then trying boiled egg several months later and when he was fine with that, introducing the last stage (raw egg on his skin) at home.

First of all, we had to go through numerous questions with the nurse, then the doctor, then doc had to prescribe piriton and epipen just in case. All this takes ages. I think they also did temperature, pulse, blood pressure as a starting point.

Then, they gave ds a tiny bit of sponge finger and waited 15 mins and checked the temp/blood pressure etc again.

Then we waited about half an hour and they repeated this with a larger piece and waited 15mins before repeating the checks.

And again with a still larger piece.

Repeat several more times, I don't remember how many times. And then we were told to wait two hours before we were allowed to go home. We were there from around 9am til 3pm if I remember correctly.

Our hospital had plenty toys etc, but it might be an idea to bring stuff for your ds to do while you are there.

Good luck, I hope it all goes well.

mummynoseynora Thu 28-Jul-11 22:01:15

Thanks very much - hugely helpful!

Just hope it does go ok!

Dukandoit Thu 28-Jul-11 22:04:11

They may just touch the cut strawberry on his skin first outside his lip, then a little later just inside his lip, before getting him to eat some (with the temperature checks etc as mawbroon said). With very severe allergies that alone will cause a reaction.

Good luck.

mummynoseynora Thu 28-Jul-11 22:09:15

the time when he had the rash was just a tiny bit of strawberry which mostly he spat out- maybe swallowed 1/10th of a strawberry ... the rash was far worse around his mouth and hands where he had got it out of his mouth

One thing I worry about it the reactions have taken quite a while (I think) to show each time... a couple of hours I think - although the first time he wasn't feeling well, but a couple of hours before he was sick (was half a strawberry) and the second time was about the same amount of time before I noticed the rash, but might have been there sooner ... I don't know!

Just not looking forward to tomorrow!

trixymalixy Thu 28-Jul-11 22:10:57

I imagine it'll be similar to the tomato challenge DS had.

They taped a bit of tomato to his arm, left it for 15 mins, the rubbed on his cheek, rubbed on his lips, then he had to eat some, all with 15 minutes in between to check no reaction.

Make sure to take plenty of snacks for afterwards as your DS will not be allowed to eat during the challenge, which could go in for a while. Also. If you have a DS or similar take it as it will be a long day.

trixymalixy Thu 28-Jul-11 22:11:45

They make you wait for 2 hours after the last exposure to make sure no delayed reaction.

mummynoseynora Thu 28-Jul-11 22:22:06

ah thanks Trixy

he's not quite 19m so entertaining shall be interesting wink

Meglet Thu 28-Jul-11 22:22:49

DS did a peanut challenge. Pretty much like everyone elses experiences. BP, temp taken first then dab of food on lip, waited for 30 mins or so, then a dab on the tongue. And so on for a few hours until he'd managed to eat a whole peanut cookie.

We spent the day in a well equipped day room and the nurse would pop back every 20 mins or so to see how he was doing. Like the previous posters we had to wait for 2 hours after the last dose just to make sure he was ok.

He was allowed to eat lunch though, I think we took sandwiches. Mind you, by that point he'd managed to get a fair bit of peanut in him so we were almost out of the woods.

He still has strong allergies to kiwi and pine nut and as the skin prick test results were so bad we aren't allowed to risk a food challenge.

Hope it goes well tomorrow, its nerve wracking but they know what they're doing and can deal with any reactions.

DarftApeth Thu 28-Jul-11 22:48:14

When my ds had his egg challenge at age 7, we were in a single room off the main ward. It took ages to get going, lots of faffing (I think they were waiting until a member of staff could be guaranteed to be free for the whole of the challenge as someone had to be with him the whole time).

Ds had to have a canular inserted first (because he gets asthma symptoms from some allergies). That was the worse bit, the rest was just boring!!

Then, as others have said, exposure started with rubbing a piece of egg on his arm, taking blood pressure and temp after a certain time, the half an hour later, rubbing egg on his cheek.

He had to wait at least half an hour before they took the next step, checking his blood pressure and temp after each step.

I think the main thing that got him through was the thought that he was ok and looking good that he might pass! Bit trickier for a little one like yours though.

I would treat it as a plane journey and have plenty of interesting activities with you. Do you have a laptop/iPad that he could watch films on? Obviously, if he reacts at any time, they will not continue the challenge.

Best of luck!

mummynoseynora Fri 29-Jul-11 17:45:13

Well that was fun.... Not!

We got there and they did all the obs etc which he was ok with. And did the skin prick ... On his back as he wouldnt keep his arm still! That came back clear so onto the food challenge....

They rubbed some on his lip.... He screamed blue murder!

They gave him 1/8th of a strawberry and he was having none of it! Spat it out etc... The nurse mashed it and I managed to get some in but not all
So in the end they abandoned the challenge, to be attempted again when he's a bit older and open to bribery!

In the meantime we stay off them still...

trixymalixy Fri 29-Jul-11 19:31:34

That sounds very familiar. DS was a bit younger than that when he had his first food challenge. I had to try and trick him with his dummy to get anything into him!!

Better luck next time!

mawbroon Fri 29-Jul-11 19:37:00

Aw, sorry to hear it didn't go smoothly.

I've been told by the allergy docs that the mouth can sometimes tingle to alert the person that they have come in contact with the allergen. Maybe this happened and your ds reacted accordingly.

mummynoseynora Fri 29-Jul-11 20:15:21

could well be mawbroon.... sigh.... oh! and I had to keep him on the bloody bed for the 3 hours or so of the challenge (one hour plus the 2 to wait) ... I had to watch 6.... 6! episodes on the hell that is in the night garden.....

<wail>

where's my wine

DarftApeth Fri 29-Jul-11 21:21:17

Aww, well thank god for the hell that is In The Night Garden!!

Sorry you didn't get any answers though.

Mawbroon is right, Ds definitely knows/feels as soon as something goes in his mouth that has nuts in, so maybe your ds knew too.

mummynoseynora Fri 29-Jul-11 22:21:42

he did the grabbing pulling it out of his mouth during the second incident (where he had a tiny amount in a yoghurt and came out in a rash) so that is what I think too.... ho hum!

babybarrister Sat 30-Jul-11 08:16:27

oh dear! is there ever a "good age" though as by 3 they know what their allergies are so I found it quite difficult to get DS to eat the egg having told him for years that he would be ill ...

I know that with the 7 year olds and above the psychological side really becomes important.

I would definitely trust yours and his instincts re strawberries - I am absolutely positive [sadly] that they will tunr out to be correct. I am a great believer in there being a likely link between food which DC hate and food to which they are allergic too [though see mine and others postings at the end of the thread about milk in fruit juice to the contrary ,,,,!]

good luck!

CokeFan Sat 30-Jul-11 08:45:31

Oh dear - I'm sorry. It's disappointing when you've spent the day in hospital and they don't pass the challenge so you know at the very least you're probably going to have another day in hospital doing it all again.

We've got an egg challenge next week for dd (failed it at 1/2 teaspoon last year with the ordinary egg challenge but starting with baked egg first this time). Skin prick test was negative this time and they took blood but we haven't heard about the result yet. We also think she can tell if she has something she's allergic to because she refused to eat any more before the hives showed up last time. She's also allergic to cmp and they're not ready to challenge that yet.

I'm not looking forward to getting up at stupid o'clock to get to Bristol for 8.30 and having to entertain an almost 3yo for the day while they prod at her. Mind you, she is going to hospital to eat cake. We're taking some dvds. We found out last year that they have portable dvd players.

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