Children’s Allergy Service – Children’s Food or Medication Challenge

Why does my child need a food /medication challenge?

A challenge is the best way to determine if an allergy to food / medication has resolved, or still causes the child to react.

Is a challenge safe?

We usually only recommend challenges for children we suspect will no longer react to the food / medicine. Most challenges are performed in the hospital where we can monitor your child for any signs of a reaction.

There is always the potential that a child can have an allergic reaction during a challenge, which is why we observe them closely during the challenge.

Challenges that are performed at home are reserved for those children that we feel are at very low risk of having an allergic reaction.

What happens during a challenge?

We will give your child increasing amounts of the food or medication they are being challenged to. We will observe them for at least 15 – 20 minutes between each stage.

If your child has an allergic reaction during the challenge, they will be given the appropriate medication and the challenge will be stopped. If their reaction is severe, they may need to be admitted to the hospital overnight.

All children having a challenge will be monitored for 1 – 2 hours minimum, following their challenge. What do I need to do before the challenge?

What can happen during an allergic reaction?

Food / medication challenges can cause an allergic reaction. Most reactions are mild – affecting the eyes (itchy, red eyes), nose (runny nose, itchy), mouth (lip swelling), skin (hives, itchy rash) or the gut (vomiting or diarrhoea).

Anaphylaxis is the most severe of these symptoms and can involve the airway, breathing or circulation (difficulty in breathing and / or low blood pressure).

Anaphylaxis is very unusual during a challenge.

Does your child have hayfever?

If your child needs daily antihistamine, it is not recommended they have a food / medication challenge during the pollen season. Please contact us to rearrange for another challenge date when your child can safely and comfortably stop their antihistamine treatment.

What do I need to do before the challenge?

• Please inform us if your child has reacted in the last six months to the food / medication we are challenging them to.
• Please inform us if your child is already eating the food we are challenging them to.
• For food challenges, we will ask you to bring the food challenge in with you.
• If you think your child may struggle to eat the food we are doing the challenge to, you can bring their favourite foods with you to help disguise the taste of the challenge food.
• Please contact the Children’s Allergy Nurses if your child is unwell (cough, cold, viral illness, high temperature, flare of asthma / eczema / hayfever) in the week prior to the challenge. We will likely need to postpone the challenge, to reduce the risk of an allergic reaction.
• Please arrange childcare for any other children, as your child will require your undivided attention during the challenge.
• The challenge waiting list is very long. If you do not inform us that your child will not be attending for their allergy challenge, we will remove their name from the waiting list.

What do I need to do on the day of the challenge?

Please inform us as soon as possible by phone or email, if your child is unwell and the challenge needs to be rescheduled.

It is best to do a food challenge on an empty stomach. Please give your child only half their usual breakfast or lunch on the day of the challenge.

Medications – please give your child all their usual medications and inhalers, except for their antihistamines.

Please bring your child’s rescue medications (antihistamine, inhalers and adrenaline injection auto-injectors) with you.

Please also bring:

• A packed lunch for yourself.
• Your child’s favourite toys / games.
• Your child’s usual plate, cup or beaker.

What happens after the challenge?

If your child successfully completes the challenge, we will observe them for two hours as some children can have delayed allergic reactions.

You will be provided with post-challenge information.

Your child can begin to introduce the new food / medication beginning the day after their successful challenge. It is very important the the food is introduced and given regularly following a successful challenge.

If your child does not successfully complete the food / medication challenge, they will need to continue to avoid the food / medication. We may try the challenge again at a later date.

If you have any concerns or questions before or after the challenge, please contact the Children’s Allergy Nurses.