Oral Food Challenge

[HappyKite56]

My daughter was diagnosed with a brazil nut allergy aged 6 after reacting to a tiny bite of one and has carried Epi-pens ever since. She is now 11 and has recently had blood tests to confirm if she is still allergic. We have received a letter to say the blood tests have shown she is not allergic and they are happy to proceed with an oral food challenge. I am delighted that she is now possibly no longer allergic but incredibly worried about doing the food challenge. Does anyone have experience of this or suggest what I could ask/need to know before we proceed. Thanks

I just wondered if anyone had experienced oral food challenges, particularly with nuts, to help me work out what to expect. Thanks

My dc have had oral food challenges to egg and milk at hospital, but the process will be the same.
The hospital should provide you with the info you need beforehand. You’ll be bringing the food in yourself so in your case the Brazil nuts.

They start with a trace amount, just rubbing on the lips. Then gradually increase the amounts that are eaten every half an hour. The food is weighed so they know exactly how much is taken and they monitor your dc after each dose. You’ll be there fir at least 3 hours.

When my dc had theirs there were other children in the clinic who also were having food challenges, some with nuts and the procedure is exactly the same.

If a child became unwell, the nurses would give piriton straight away. They will give 2 doses of the reaction continues. They also have epipens of course and the idea is that having the challenge in hospital is the safest way to do it as they are well prepared for any allergic reaction.

If they pass the food challenge then hooray! You will need to make sure they carry on eating it regularly though to prevent them becoming allergic to it again.

Thank you for your reply. She reacted so quickly to just a small fragment of nut when she first ate one that I just cannot imagine her being anywhere near one, let alone having it rubbed on her lips! I'm very nervous about it but just hoping for a good outcome!

Between them DS' have had several allergy challenges, but not to nuts. They are normally incredibly safe as clinicians won't go ahead unless they believe a child won't react. DS' had SPTs as well as bloods before deciding whether to go ahead with a challenge. If that isn't the case for DD I would want to know why.

If DD is on antihistamines or oral steroids you have to stop them prior to the challenge.

Thanks for your reply. She is not on antihistamines, oral steroids or any other medication, we just carry 2 Epi-Pens everywhere with us. She did have skin prick tests as part of her initial diagnosis so that is years ago now, and they were positive. Would you expect her to have them again now before they proceed with the food challenge? The hospital have not rung to make the appointment yet so I am compiling a list of questions to ask when they do!

DS's have always had recent negative SPTs before proceeding. Some were done prior to arranging the challenge and some like an antibiotic challenge were done on the day.

That's interesting, thank you. I will definitely ask if they plan to carry that out first.

Thank you so much for the advice, we have been for a skin prick test today and she had a strong reaction!

I'm pleased you had SPTs in the end, I always thought it was best practice to do them prior to challenges. Sorry to hear the results weren't favourable, although better you know now than during a challenge.

Hello @happykite56 my son is allergic to Brazil nuts too.

Is he allergic to any other nuts? My daughter has been tested for all other nuts but it is only brazil nuts.

I actually received a letter last week asking her to go in for another appointment in September, I did ring and question why they needed to see her as it will only be just over a year since they last saw her and nothing has changed so I feel like we will be wasting the hospitals time!

@happykite56

just brazils. Hope it stays that way.

It’s weird that your blood tests were negative but skin pricks positive!

ds2 has just tested negative blood wise to pecan and macadamia so I had been planning to reintroduce but now I wonder if he needs skin prick too…

It’s actually more common than you think, which is why it is often considered good practice to do SPTs before undertaking an oral allergy challenge.

I wouldn’t reintroduce without doing a challenge in a hospital setting.