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Important
If you reschedule your appointment date more than once,
we will remove your child from the waiting list.
About food challenges
A food challenge is a test that we perform in hospital to diagnose food allergy.
We give your child the food under hospital supervision to monitor whether they have an allergic reaction.
If your child tolerates the food and experiences no allergic reaction, you can start to include that food in their diet. You can do this 48 hours after your child has completed the food challenge. We advise you to include it at least 2 to 3 times a week to maintain their tolerance.
If they do not tolerate the food, they will need to continue avoiding it.
What happens during a food challenge
You and your child can expect the following during a food challenge.
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Remember to bring with you the food that we will be testing. |
- We start by giving a tiny amount of the food we are testing, and gradually increase it, until we reach the final portion.
- The final portion we give to your child is the amount they would eat as a typical mealtime portion.
- We increase the amount of food we give over 4 to 5 portions.
- We monitor your child between portions for any signs of allergic reaction.
- We then wait for 2 hours to ensure your child has no reaction when we reach the final portion.
- A food challenge usually lasts up to 4 hours to complete if there are no reactions.
Benefits and risks
Benefits
- Less anxiety around eating certain foods.
- A way to safely find out if your child can eat certain foods.
Risks
- There is a risk that your child may have an allergic reaction during the test.
- Allergic reactions can vary from mild to moderate or severe (anaphylaxis).
Important information
It is important that your child is well, showing no symptoms of asthma, with well controlled eczema, and no cough, fever or tummy upset in the 7 days leading up to your food challenge appointment.
If your child is not fit and well, get in touch with the paediatric admin team at least 48 hours before your appointment (see Contacts section).
How to prepare for your food challenge
| If your child's food challenge involves a recipe, remember to make the food at home (using the recipe we send you) and bring it with you on the day. |
Children often feel anxious about eating a food they have previously been asked to avoid.
It is a good idea to prepare your child for their hospital visit so they know what to expect. Talk to your child in advance so they have time to ask questions about the food challenge.
It can be helpful to bring familiar toys and books for younger children to help distract them during their appointment. Older children may wish to bring a book, a digital device (ideally with pre-downloaded content) or headphones.
Can your child take their usual medicines before their appointment?
Read the following information carefully before your child’s appointment.
Antihistamines and travel sickness medicines
| Stop giving your child the following long-acting antihistamines 5 days before their food challenge: |
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| Stop giving your child the following short-acting antihistamines 2 days before their food challenge: |
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| Stop giving your child travel sickness medicines and cough syrups 2 days before their food challenge. |
Asthma medicines
It is important that your child is fit and well before their appointment.
If your child currently uses an inhaler to manage their asthma, it is important that they continue to use their preventative (brown) inhalers right up until their food challenge. This will not affect the results of their food challenge.
Important information
If your child needs to use their blue reliever (salbutamol) inhaler in the 7 days prior to the food challenge, get in touch with us at least 48 hours before your appointment (see Contacts section).
If your child is unwell, contact us 48 hours (or as soon as you can) before your appointment. It may not be safe to carry out the food challenge and we may have to reschedule.
What to bring with you on the day
Bring the following with you on the day.
- The food that is being challenged (and which we advised you to prepare), in a form that your child is most likely to accept. For example, if a younger child (age 0 to 5) is having a food challenge to nuts or tahini (sesame), bring at least 2 tablespoons of pure, smooth nut butters or tahini or finely ground whole nuts. If an older child (age 6 to 16) is having a food challenge to a nut, bring a packet of single whole nuts. If you bring egg, bring 2 eggs prepared as advised by the allergy nurse (eg 2 hard-boiled eggs).
- An additional food like yogurt or fruit puree. We can mix the challenge food into this. This is particularly helpful if your child does not like the taste or texture of the challenge food.
- A packed lunch and some snacks that your child can eat afterwards.
- All your child’s allergy medicines, Epipens and antihistamines, as well as asthma inhalers and spacers.
- A bottle of cold water.
- A change of clothes for you and your child, in case of vomiting.
- If the food challenge involves using a recipe, we will send this to you with your appointment letter.
What to expect at your appointment
You can expect the following on the day of the food challenge.
- On arrival a nurse will greet your child and weigh them. They will complete a set of observations of your child, including temperature, heart rate, pulse, oxygen level and blood pressure. The nurse will also listen to your child’s chest.
- The nurse will explain the procedure in detail and you will have the chance to ask questions.
- If you are happy to go ahead with the food challenge, the nurse will ask you to sign a consent form.
- The nurse will supervise your child while we give them the challenge food. We will increase the portion every 20 minutes.
- The nurse will observe your child for any signs of allergic reaction in between portions.
- When your child has eaten all the portions of the challenge food, we will observe them for a further 2 hours.
If your child has an allergic reaction
If your child has an allergic reaction at any point during the food challenge, we will assess immediately and treat your child according to their reaction.
We will then monitor your child for 2 hours until their symptoms have improved and we can discharge them home.
If your child has a severe reaction, we may admit them to hospital.
What happens once we know the results
If your child had an allergic reaction
If your child has an allergic reaction to the challenge food we will advise you to continue to avoid the food.
We will update your child's allergy action plan. This can be shared with their school and taken with them when they travel.
If your child tolerated the challenge food
If your child tolerates the challenge food, we will advise you to wait for 48 hours before introducing the food into their diet.
This allows you to monitor your child at home, for signs of late reaction.
If there are no signs of late reaction, you can introduce the challenge (new) food into your child’s diet regularly. We suggest you give the food to your child at least twice a week, in typical mealtime portions, or as recommended by your allergy nurse or dietitian, to maintain their tolerance to this food.
Follow up
After your child's food challenge, we will arrange a follow up appointment if necessary.
Contact information
Kingston Hospital Paediatric Admin team