Food Challenge Testing

At UPMC Children’s Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this test and invite you to participate. Please read the following information to learn about the test and how you can help.

Fast Facts About Food Challenge Testing

• A food challenge test is the most accurate way for the doctor to tell if your child is allergic to different kinds of food.
• The test uses increasing amounts of the food being challenged, which may cause an allergic reaction. 
• The test is done at the doctor’s office or the hospital in case an allergic reaction takes place.
• Food challenge testing may take an entire day, but typically it takes about 3 or 4 hours.
• Your child will have only 1 food challenge on any day of testing.

What Is Food Challenge Testing?

Food challenge testing allows the doctor to determine if your child is allergic to a particular food.

• During the food challenge test, your child will be given certain foods in increasing amounts. 
• After your child swallows each portion, the doctor will wait to see if he or she shows signs of an allergic reaction.
• If no reaction takes place, your child may be asked to eat a slightly larger portion of that food type.
• The food challenge test is done at a doctor’s office or hospital. Because of the risk of a severe allergic reaction, you should never attempt a food challenge at home, unless advised otherwise by a doctor.

Home Preparation

To make sure that the test results are accurate:

• In the 2-week period before the food challenge test, you should make sure that your child does not eat any foods that are suspected allergy triggers.
• In the 4 days before the test, do not give your child any antihistamine (an-tee-HIS-ta-meen) medicine, including:
• Prescription antihistamines, such as fexofenadine (Allegra).
• Over-the-counter antihistamines, such as Loratadine, Alavert, Claritin, Benadryl or Chlor-Trimeton and cetirizine (Zyrtec).
• Check first with your child’s doctor to make sure it’s safe to stop these medications.
• In the 2 hours before the food challenge test, do not give your child anything to eat or drink except water.

Before the Food Challenge Test

Food challenge testing is done through the Division of Pulmonary Medicine, Allergy and Immunology of Children’s Hospital.

After you have registered your child at the desk, you will be asked to sit in the waiting area.

• You and your child will be called to the testing room and asked some screening questions by one of the doctor’s assistants. The assistant will take your child’s vital signs, weight and medical history. 
• You may ask any questions or discuss concerns about your child’s treatment at this time.
• Your child may bring a favorite blanket or toy to make him or her feel more comfortable.
• You may bring a few favorite books, games or DVDs to keep your child busy during the testing.

The Food Challenge Test

The challenge will be supervised by a doctor or nurse practitioner who will work with your child during the food challenge test.

• To begin the test, about 1% of the serving size will be fed to your child. 
• After each dose of food, your child will wait about 15 minutes to see if a reaction takes place. If the first amount is tolerated, and no signs of an allergic reaction are seen, gradually increasing amounts of the same food will be given every 15 to 20 minutes until the entire serving has been eaten. 
• Your child will then be observed for at least 1 hour following the challenge to ensure that no reaction takes place. 
• If there is any sign of an allergic reaction at any point during the challenge, your child will immediately receive the appropriate medical treatment and the challenge will be stopped.
• If your child is able to eat a complete dose (equal to a normal meal-size portion) without any allergy symptoms, an allergic reaction to that food can be ruled out.

A Parent’s/Guardian’s Role

During the Food Challenge Test

The most important role of a parent or guardian during the test is to help your child stay calm and relaxed. The best way to help your child stay calm is for you to stay calm.

After the Food Challenge Test

After the food challenge test, the doctor will want to keep an eye on your child for about 1 hour or sometimes longer to make sure that no allergic reaction takes place.

• When the doctor feels that your child is no longer at risk of reacting to the food challenge, you will be allowed to take your child home.
• Once at home, there is a rare chance that your child will have a delayed allergic reaction to the earlier testing. Contact your doctor’s office immediately if that happens.

Special Needs

If your child has any special needs or health issues you feel the doctor, nurse practitioner or nurse performing the test needs to know about, please call the Division of Pulmonary Medicine, Allergy and Immunology at Children’s Hospital of Pittsburgh before the test and ask to speak with a nurse. It is important to notify us in advance about any special needs.