Minimum age for food challenge in hospital?

[garliclover]

To cut a hugely long story short, I forgot to ask this question when I took my 18mo DS to see the allergy specialist last week. She said that he wasn't likely to outgrow any of his allergies soon and went back on her initial opinion that his milk allergy was resolving (it obviously isn't: hives everywhere as soon as he touches a drop). She also said at a previous appointment that he was too young for a hospital food challenge because he wouldn't cooperate.

So was just wondering how young your DCs were when they first had a challenge in hospital, and how it went for them...?

I suppose I'm impatient and hoping he'll outgrow at least one of his allergies before he's 2 or 3.... but he probably won't.

DS1 was 18 mo, for milk. He didn't co-operate but then again he didn't pass either so I imagine the itching/burning feeling in his mouth was telling him not to. He was tested again, and passed, at 3 btw.

We were told that he wouldn't be offered a peanut challenge before the age of 5 as 'it can be hard for them to get the children to eat the nuts'. This was fine by us and frankly at 3/4 there was no way we could have got him to even to try one, even if they thought it was safe.

7 for his first cooked egg challenge.
however a 4 yr old was there, for the same.

allergies are individual , and depend on lowering test rates before being considered for hospital food challenge.

its a very long day, and increasing amounts of the allergen is added to small portions of food during the day. our son at 7 found this very difficult to do. we have also failed food challenges as well, confirming that allergen rating was dropping, but not enough to trigger outgrowing.

3 for wheat challenge which didn't go very well as he had very bad reaction. He also found it very confusing as we'd always told him he couldn't eat bread and suddenly we were telling him he had to eat it and then it made him ill so he was very distressed. Thankfully, it was all resolved quite quickly but I can't say I'm looking forward to the next one - he will have to have milk, egg and nut challenges at some point in the future but not until his skin prick and blood test results come down and so far they have got worse not better so think it'll be a while yet!

We've just had a (successful!) baked egg challenge for DD1 - just turned 4. Still can't have more lightly cooked or concentrated egg or any dairy, but its a brilliant start.

She was also old enough, at 4, to understand what we were doing and why, and what might happen. So she was an absolute star (kept saying 'I'm not being sick yet mummy!'), ate everything quickly and we had no problems. I think at 3 or younger, it might have been tricky to get sufficient quantities into her (they have to eat quite a huge amount in the end).

Like your DS, she always used to react to touch. This stopped around age 2 or 3, so hence I requested skin prick tests, which were improved, and then the (first of hopefully many) challenges. Since the waiting for each appointment is 3-6 months, it was age 4 before we got here. But in retrospect, I'm glad we didn't rush it. Statistically, the average age for growing out of allergies is more like 5+, rather than younger, so best not to depend on this outcome too much...

My ds had baked egg challenge at 2.2, which he passed, but just failed boiled egg at 2.8.

DD had a soya challenge at 11 months, passed. And a baked bean challenge at 14 months, failed.

She's also had egg and milk challenges 6 weeks apart at 4 1/2.

In some ways, it was easier when she was a baby, because she didn't know what was happening, and didn't really have the fear association that she certainly had at the last set of challenges.

The long day/coaxing the food in is difficult at any age, but I would certainly say it was harder when she was older!

I suppose it depends on the reason for the challenge, too. DD was challenged at such a young age because she has a long list of allergies, and so her diet was pretty limited. The soya and bean challenges were important to try and vary her diet. Also, we had had some borderline results from igE so a food challenge was necessary. I

f you have already seen a clinical reaction to milk, then a food challenge would be (an expensive) waste of everyones time! What do her blood/skin prick results say?

No harm in leaving it a bit longer?

Also worth noting perhaps is, like many other children, her symptoms changed too - no more hives/swelling. However, this did not mean that her allergy had lessened, just that her symptoms changed...This is when food challenges can be really useful.

Really interesting replies -- thank you! And lukewarm, congratulations on the baked egg challenge! Fantastic news.

Looks like we might just have to be a bit more patient. I suppose we had a some false hope when we were initially told that DS's blood test results showed the milk allergy was lessening. But when we told the consultant about his reactions to drops of milk at nursery, she said that we should put off that challenge. Also the egg challenge, because the test results are sky high for egg as well as wheat. On Thursday he's getting tested for sesame and lentils (has had reactions but never been tested for them) and for almonds and peanuts as well. This is all blood tests -- we weren't offered skin prick tests because it didn't look to the consultant as though DS would be patient enough!

Strangely, a soya challenge was suggested in a letter, but by the time it arrived we had already (on the verbal advice of the consultant) given him a whole load of soya yoghurt at home, thankfully with no reaction! And even more strangely, at this appointment the consultant seemed surprised that he hadn't reacted to soya despite reacting to lentils. TBH I'm very confused about the whole thing and hoping it will all go away. One day, one day...maybe.

We're extremely lucky, however, in that he will be seen again every 6 months instead of 12, which by the sound of things is unusual.

I think your consultant may have been coming from the point of view that soy beans and lentils are in the same food group (along with peanuts), but that doesn't necessarily mean that you have the same reaction to all of them.

DD1 had lentil reactions for a while, although didn't really react on the skin prick so they've never really believed that one. Thank goodness she has never had soya allergy though, as that would be a true pita combined with the dairy. Good news that soya, at least, is OK for your DS.

I can sympathise with the 'one day this will all go away' feeling - I keep putting off booking overseas holidays until we don't have food issues to deal with, maybe a bit too optimistic!

Good luck with the other tests.

May I ask what sort of reactions your DD had to lentils, and was it to all types? Our consultant thought that he might be fine with some types and not others, but if I even begin to go down the route of "oh he's fine with red split lentils, but has a terrible reaction to Puy lentils" then noone will take me seriously (I think the nursery staff probably think this whole allergy business is all rather pfb anyway! you probably know exactly what I mean). Does your DD still avoid lentils? And is she allergic to peanuts as well?

It was a while ago, whilst we were weaning at about 6 or 7 months - did lots of lentil soup, so it was red lentils. Lentil allergy is apparently much more common in Mediterranean countries, where its a common weaning food. It was a similar reaction to egg - redness, hives and swelling round the mouth, frenzied scratching all over the body, trying to tear her clothes off, so I had to strip her down to cool her off and cover her in steroid cream (didn't know about piriton then, doh ). Not quite as bad as egg though, no coughing/wheezing, and definitely not as bad as milk which was horrendous.

She was already obviously allergic to milk, so it didn't take me long to put two and two together, and take lentils out of her diet (although slightly longer than it should have, as I didn't believe it could be lentils causing an allergic reaction initially ).

Even though the skin prick for lentils at about 18months barely raised a bump, we've avoided them (fairly easy to avoid in the grand scheme of things!). Recently, since she seems to be less allergic in general, I've let her have a taste of soup I've had with lentils in, and she seems fine. But thinking about it, it may have been Puy lentils in the soup, so a different kind, and I've not given her any great quantities of lentils to test her - doesn't seem worth it at the moment!

No, she isn't allergic to nuts, thank goodness.

Yes I know what you mean - its probably best just to tell nursery no to any kind of lentils! Rather than saying he can only eat organic ones harvested at full moon or whatever