General Information

The oral food challenge (OFC) is used to confirm a food allergy or show that the food allergy is outgrown
This test has the potential to cause a serious reaction and should ONLY be performed by a trained allergist at a medical facility such as the hospital or clinic
The test must be performed when you / your child is feeling well. If you / your child has an asthma flare or are sick please call the clinic to reschedule the appointment
Only 1 food will be tested at each appointment
Each appointment is usually 3 - 5 hours
Avoid antihistamines one week before the OFC
Please bring your epinephrine auto injector to the appointment

Oral Food Challenge Procedure

Before the OFC begins, your doctor will assess you / your child to make sure it is safe to go ahead with the challenge
During the OFC you / your child will eat the food in measured doses, starting with a very small amount and increasing with each step
There are usually 5 steps with 15 minutes in between each step
Before each dose you / your child will be assessed for signs of a possible reaction - If there are no symptoms, you / your child will receive the larger dose
Once you / your child have the full amount of the food you must be observed in the clinic for an hour to make sure there is no reaction
If there are any signs of a reaction such as hives, swelling, coughing, wheezing, abdominal cramping, vomiting, diarrhea, dizziness or fainting the OFC will be stopped
Reactions range from mild hives to severe anaphylaxis
Treatment options include oral antihistamines for mild reactions and epinephrine injection for anaphylaxis
If the reaction is severe you / your child may require assessment and observation in the emergency room

How to Prepare Your Child for the Oral Food Challenge

Children often need to be emotionally prepared for the OFC
For children younger than age 6 years you might find it helpful to so some role playing to prepare them for the OFC
For older children it helps to explain the procedure so they know what to expect. Do not avoid discussing the OFC until the day of the test
We will encourage your child to eat the food but will never force them to do so. If he or she absolutely refuses to eat the food, the test will be stopped and rescheduled for another time
The OFC is a long clinic visit so it is helpful to bring things such as books, toys and games to keep your child occupied
You can bring safe snacks (foods that the child has eaten before without a reaction) that can be eaten in the 1 hour observation period after the OFC is completed