Food Challenge
Your child has been asked to attend the Paediatric Assessment Unit on Kingfisher Ward for a food challenge. This leaflet includes information on what is involved in a food challenge, and how to care for your child following the challenge.
What is a food challenge?
A food challenge is a procedure to find out if your child can eat a certain food without having an allergic reaction. The challenge will either be:
- A diagnostic challenge to confirm whether or not your child is allergic to the food
- A resolution challenge to confirm whether your child has outgrown their allergy.
On the day of the challenge
Once you and your child have arrived at the Paediatric Assessment Unit, you will be looked after by the allergy nurse specialist. The nurse will initially take a brief allergy history from you and ask about your child’s general health. Then they will take some basic observations from your child, including temperature, pulse, blood pressure, oxygen saturations, height and weight.
The nurse will then explain the process and you will have some time to ask any questions you may have. If you are happy to proceed at this point, you will be asked to sign a consent form and then the challenge can begin.
Unless otherwise instructed, YOU must bring the food for the challenge.
You should receive information with your appointment letter regarding which food to bring to your child’s food challenge. If you come without any food, we will be unable to do the challenge.
How is the challenge performed?
The challenge is performed by feeding your child the identified food, bit by bit in increasing doses, until a maximum measured amount is successfully eaten. At each stage of the food being eaten, your child is carefully checked for signs of an allergic reaction. Once all the doses have been eaten, you will need to stay on the ward for two hours to make sure that there is no delayed reaction to the challenge.
Food challenges can cause an allergic reaction. We will assess your child throughout the challenge. If your child shows symptoms of an allergic reaction, we will stop the challenge, assess, and treat as necessary with review from a doctor if required.
The appointment usually takes half a day (normally the morning) so please bring your own toys, books, iPads, computers, phones, or anything else from home to entertain your child. We will also have members of our play team available on the day who can bring activities to the bedspace.
What if your child does not like the food they are trying?
Lots of children do not like to experience new foods, which is perfectly normal. Please feel free to bring some food from home that they do like to help disguise the taste and to help them eat it. You could also bring some food that your child likes (favourite foods) to eat after they have had the food they are being challenged to. If you are worried about this, please feel free to discuss this with the nurse in advance of the appointment.
After the challenge
If your child has reacted during the challenge, you will need to avoid the challenged food and we will give you an emergency treatment plan, if you do not have one, which includes clear instructions on how to treat an allergic reaction. Your child may need to remain at the hospital for further observation, normally two to six hours, depending on the severity of the reaction.
If your child does not react to the challenge, it is very important to introduce the food into your child’s diet, regularly, after 48 hours to ensure your child maintains an immune tolerance to the food. Advice will be given before you are discharged.
Medications your child may be taking before the test
Antihistamines
Your child may be taking prescribed medications containing antihistamines, eg Chlorphenamine, Loratadine, Cetirizine, Piriton®, Clarityn® or Zirtek®. Most cough medicines also contain antihistamines.
It is essential that all these are stopped five days before admission as they can hide symptoms of an allergic reaction during a challenge.
If these are not stopped, it will not be possible for the test to be performed.
Asthma medication
Your child should continue to take their regular preventative asthma inhalers (usually brown, orange or purple).
If your child is wheezy, coughing or has needed their blue inhaler more often than usual in the two weeks before the challenge, please contact the allergy nurse on 01305 254279 before the challenge day to discuss this further.
If your child has eczema
It is important that your child’s eczema is under good control before the challenge. If your child is having an eczema flare in the week before the challenge, please ring the allergy nurse on 01305 254279 to re-arrange the appointment.
If your child is unwell
It is important that your child is well when undertaking the challenge. If your child is unwell including a cough, a cold, a temperature, diarrhoea or vomiting, rash or worse eczema than normal, please contact the allergy nurse as your appointment will need to be re-scheduled.
If your child carries an adrenaline auto injector (EpiPen®, Jext® or Emerade®) please bring it with you on the day of the test.
Contact numbers
We hope that you have found this information useful. If you have any questions or are worried about anything, please speak to the following Dorset County Hospital staff:
Allergy Nurse Specialist: Juliet Lyus 01305 254279
Consultant: Dr Wylie (Secretary): 01305 253331
Consultant: Dr Newman (Secretary): 01305 253331
Feedback
If you would like to give us feedback on our Paediatric Community or Specialist Nursing Service, please complete our patient related experience survey: https://dchft.onlinesurveys.ac.uk/paediatric-specialist-and-community-nurses-questionnaire
All responses will be treated anonymously and in the strictest confidence and only used to help us improve our service for patients.
Useful websites
About this leaflet
Author: Juliet Lyus, Paediatric Allergy Nurse Specialist
Written: December 2022
Approved: May 2023
Review date: May 2026
Edition: v1
If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk
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