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We provide comprehensive care for infants, children and teens with food allergy and/or food intolerances.
Our goals are to:
Signs of an allergic reaction to food or medication may include itchy mouth, hives, swelling, gastrointestinal symptoms such as vomiting or diarrhea and — in severe cases — swelling of the throat and difficulty breathing. It's important that anyone who experiences difficulties breathing goes to the emergency room right away.
When your child sees an allergist at the University of Chicago Medicine Comer Children's Hospital, they will take a comprehensive medical history, perform a physical exam and may use a skin prick test and/or blood test to check for food allergies. If allergy test results and medical history are inconclusive — or if they do not show whether or not your child has (or still has) an allergy to a specific food — we may recommend an oral food challenge test.
If your child has a food allergy, our team will work with you to develop a comprehensive management plan. This plan will include strategies for avoiding foods or medications that trigger reactions, as well as creating an emergency plan to treat reactions if they occur. Your provider may discuss experimental treatments for food allergy.
If allergy test results and medical history do not show for certain whether or not your child has (still has) a food allergy to a specific food, we recommend that your child have an oral food challenge test.
The oral food challenge involves eating a serving of the allergic food in a slow, graded fashion under medical supervision. The food challenge procedure is the most accurate test to determine whether a food needs to be avoided or will no longer need to be avoided.
The food challenge is undertaken when your child is in generally good health and can discontinue antihistamine for a brief period (usually 3 days) before the test.
During the food challenge, your child will be given very small amounts of the specific food being tested. If tolerated, increasing amounts of the challenge food will be given with close observation at each stage.
Your child will be observed for symptoms such as itching, rash, abdominal pain or difficulty breathing. If any symptoms develop, your child will be treated immediately. In most cases, this will involve the use of diphenhydramine and/or epinephrine to prevent any allergic reactions from getting worse. In studies of food challenges, many children develop mild symptoms during a food challenge that require these treatments. Very rarely, other treatments are needed for more serious reactions.
In some cases, your doctor may decide to place an IV in your child’s arm before the challenge starts. This would be used to give medicine if needed.
In some cases, the food challenge is performed by masking the food to hide the taste, and using food that looks/tastes the same but does not contain the food being tested. This is called a placebo. These procedures reduce the possibility that we would misjudge a reaction to the food that could occur from fear or distaste of the new food.
The discomforts associated with the food challenge are generally no more than those encountered when eating the food. Symptoms usually are short-lived (less than 2 hours). Symptoms may include an itchy skin rash, nausea, abdominal discomfort, vomiting, diarrhea, stuffy “runny” nose, sneezing or wheezing.
The major risks involved include severe breathing difficulties and rarely a drop in blood pressure. While a severe outcome such as death is theoretically possible, this has not occurred from medically supervised oral food challenges. The risk of a reaction is reduced by starting the challenge with very small amounts of food, administering the food over a prolonged time period, stopping the challenge at the first sign of a reaction and by not giving any food suspected to cause a major reaction.