Before and After the Food Challenge

At the Food Allergy Center at Children’s Hospital of Pittsburgh of UPMC, we want to help you and your child know what to expect before and after a food challenge.

Find out:

  • How to prepare for your child's food challenge.
  • The three possible outcomes of your child's food allergy challenge.
  • What to expect once you get home.

Before the Food Challenge

Your child should stop taking all antihistamines

Seven days before the food challenge, your child should stop taking Claritin® (loratadine).

Three days before the challenge, stop taking:

  • Allegra® (fexofenadine)
  • Atarax® (hydroxyzine)
  • Benadryl® (diphenhydramine)
  • Periactin® (cyproheptadine)
  • Xyzal® (levocetirizine)
  • Zyrtec® (cetirizine)

Keep in mind that many over-the-counter cough and cold medicines also contain antihistamines.

Please read the labels on any drugs your child may take prior to the food challenge. Avoid anything with antihistamines for at least three days before the challenge.

About asthma medications

Your child should keep taking maintenance asthma medicines, like:

  • Flovent®
  • Advair®
  • Singulair®

Do not give Albuterol®, Xopenex®, or other rescue inhalers on the morning of the challenge. If your child needs them, please call to cancel the appointment.

If your child takes drugs for other conditions, please let us know.

Your child must fast the night before: clear liquids only

Your child may not eat anything after midnight the night before the test. (That means no breakfast the morning of your food challenge.)

During this time, you may give your child clear liquids only.

What are clear liquids?

  • Water
  • Apple juice
  • Fruit juices with no pulp
  • Iced tea
  • Gatorade
  • Jell-O
  • Popsicles
  • Water ice without fruit chunks

If you breastfeed your child, you may keep doing so prior to the food challenge.

Reschedule if your child is sick

If your child is sick shortly before for his or her food challenge appointment, please call to reschedule. Allergic reactions can be more severe in a child who is already sick.

We can't perform a food challenge on a child who:

  • Is sick.
  • Is recovering from a recent asthma flare (asthma symptoms within 1-2 weeks).
  • Has a severe eczema flare or rash.

If your child arrives and is sick, we won't perform the food challenge.

Please do not bring your sick child to a food challenge appointment for an exam or treatment. Instead, we may be able to help schedule an office visit.

Possible Outcomes of a Food Challenge

There are three possible outcomes of a food challenge.

Your child:

  • Has an allergic reaction. He or she will need to continue to avoid the food.
  • Tolerates the food. In this case, your child will not eat more of that food on the day of the challenge, but will keep the food in his or her diet.
  • Refuses to eat enough of the food (a full serving), making the challenge results inconclusive.

After the Food Challenge

Once at home, there's a slight chance that your child will have a delayed allergic reaction. Contact your allergist or the allergist on call right away if this happens.

Rarely, a food allergy may recur after a child has passed a food challenge. We suggest that you keep the specific food in your child’s diet about three times per week.