Allergy Clinical Services

Food Challenge

Please bring the food to be tested and other snacks for yourself and your child. Please be on time for your appointment. A delay in starting will delay your departure in the afternoon.

Before the challenge begins

Your child's doctor will examine her, particularly her breathing and skin condition. If we do not feel that your child is well enough to safely participate in the challenge, we will reschedule the challenge.

At the start of the challenge

A small amount of the food will be given to your child. Approximately every 20 minutes, an increasing amount of the food will be given. If your child has a reaction, the challenge is stopped and your child is considered allergic to that food. If your child can tolerate a full serving of the food, the challenge is stopped and your child is considered not allergic to that food.

After the last dose of food

Your child needs to be observed for any late-phase reaction for about two and a half hours after the last dose of food. You can expect to be here from 8 a.m. until approximately 2 p.m. to 3 p.m. Children who experience a significant reaction may be observed for up to four hours or more. If necessary, symptoms occurring during the challenge will be treated in the clinic area. In an emergency, your child can be taken to the Hospital's Emergency Department.

For more information

If you have any questions or concerns about the food challenge, please call us at 215-590-2549.

Preparing for your child's food challenge

Do not give

Antihistamine medicines like ALLEGRA allergy medication, BENADRYL allergy medication, CLARITIN allergy medication, ZYRTEC allergy medication, etc. for 72 hours (three days) before the challenge. See our full list of antihistamine medicines to avoid.
Albuterol (PROVENTIL inhaler, VENTOLIN inhaler) on the morning of the challenge only
Combination medicines, e.g., EXTENDRYL medicine and many over the counter cough and cold preparations. Many of these contain antihistamines.
ADVAIR inhaler, the night before or the morning of the challenge.

Do give

Your child's usual daily maintenance medicines, e.g., ADVAIR, FLOVENT, SINGULAIR and nasal sprays.

Please call us

If you are not sure about the medicines your child is taking
If your child is sick. If your child has a fever, asthma flare (coughing and/or wheezing), eczema flare or GI symptoms, the food challenge cannot be done. If your child has these symptoms, please call us to reschedule 215-590-2549.

Food and liquids before the challenge

Your child may not have anything to eat from midnight the night before the test until the test begins. That means no breakfast the morning of the test. During this time, you may give your child clear liquids only. If your child is breastfeeding, you may continue to breastfeed your child.

Clear liquids include: water, apple juice, fruit juices with no pulp, iced tea, GATORADE drink, JELL-O gelatin, POPSICLES or water ice without fruit chunks.
The following are NOT clear liquids: milk, formula, orange juice, soda and hot cocoa. Please ask about any food or drink not mentioned on this list.

What to bring to the food challenge

Food for the challenge

2 scrambled egg prepared without butter or oil
1 pint whole milk or formula
1 pint of soy milk or soy formula

You may be required to bring another food that is not listed above. Our office will call with instructions prior to the challenge visit.

Clear liquids

Please bring about 32 ounces of clear liquids for your child to drink during the food challenge. Juice boxes, JELL-O gelatin and other clear liquids listed above are good choices.

Other things to bring

Lunch

Please bring lunch for you and your child. He/she may be permitted to eat lunch/snacks approximately one hour after the last dose of food is given.

Toys

You and your child will be here for several hours. Favorite toys, books, etc., will help you and your child stay occupied.

Change of clothing

For you and your child in case of vomiting.

Siblings

It is best if you can arrange to spend the day with just the child being tested. Space is limited and your child will benefit from your individual attention.

Reviewed by: Paulette Taylor, RN, CPN, AE-C
Date: October 2008

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