Thursday, May 24, 2012

Oral Food Challenges

How to plan for the Food Challenge Day

An excerpt from Rose Ann Miller, parent of an allergic child

Bring anything to capture attention for several hours. A new game, toy, book helps the four to five hours pass more quickly. Don’t be afraid of electronics. And, don’t be surprised if the doctors teach your child a thing or two about “Angry Birds.”

Bring supplies. The Food Allergy Center generally does not want a child to eat/drink anything other than what is being tested. Water is always fine, and you will be grateful you brought some for your thirsty child.

Prepare your child. Ask your doctor/nurse what to tell the child beforehand, depending on his or her age. An older child will probably have more questions about a food challenge than a toddler will. They should at least be prepared to spend some time at the center.

Know your child will be safe at all times. At the Food Allergy Center, food challenges generally seem “normal” and even pleasant due to the humor and compassion of the caring staff. Consuming allergens is scary for the child and adult. The good news is, the majority of times, children do pass.  To date, my son has successfully “passed” cashews, walnuts, pecans and pistachios. Nevertheless, my son has also failed a cooked egg and an almond challenge. The Food Allergy Center response was swift and reassuring, and we got through it.  And, each time he asks for or we incorporate his “safe” nuts into a recipe is a source of joy and triumph.

An oral food challenge is the most definitive procedure for testing whether someone can tolerate a specific food. A challenge involves giving increasing amounts of food every 10 to 20 minutes followed by an observation period.  The total procedure takes place over about four hours. During this time, doctors observe your child closely for any reaction. If reaction symptoms are suspected, a doctor will assess your child before continuing. If a reaction is confirmed, your child will be treated and observed further for any persistent or recurrent symptoms.

As of March 2012, the Food Allergy Center has conducted more than 200 oral food challenges with a pass rate of about 70 percent.  The “pass” rate is highest among patients whose skin tests and sIgE {previously known as radioallergosorbent (RAST)} tests—measures allergy antibodies— suggest less sensitivity, consistent with what has been shown. 

Foods challenged include some of the top eight allergens: peanut, egg, milk, soy, various tree nuts and wheat.  By offering these challenges, the Food Allergy Center has helped patients add these foods and others, like sesame, potato, rice, tomato and turkey, back to their diet after a successful challenge. Food challenges are time and resource intensive, and they can be stressful for some patients and their families. The Food Allergy Center, with key leadership from Elisabeth Scannell Stieb, RN, BSN, AE-C has invested substantial resources thanks to generous private support to develop a comprehensive set of online materials to help educate and guide patients through the process.

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