What to Expect When You're Expecting... An Oral Food Challenge

This is a pretty fresh topic in my head as our daughter had an oral food challenge last week. If you’re not familiar, or haven’t experienced one yet, an oral food challenge (OFC) is essentially a food trial to a potential allergen. An OFC is usually held at your doctor’s office over a few hour period. In our experience, the doctor divides the potential allergen into several doses, titrating the amount up by double every 15 minutes or so until a full serving is reached. For reference, an OFC is really the only definitive way to know if a food allergy is really a true food allergy (if no definitive diagnosis is made after a skin prick or blood test). Once the full serving size is met, the doctor will typically observe for a couple hours to ensure no signs of a reaction occur. However, if symptoms start to occur at any point in an oral food challenge, the challenge is stopped and the symptoms are treated immediately.

So let’s talk about the “what to expect” part. It can be a long day. And it can be a bit nerve wracking. But being prepared and understanding the purpose/procedure is so important. So in the spirit of getting all your ducks in a row (weak post-Easter joke, I know), I’ve compiled a list of things to prepare in order to be ready for the challenge once you get there.

Ask your doctor what he/she needs you to bring. He may have you bring the food for the challenge or his office may provide the food (we’ve done both). Make sure if you’re bringing the food allergen in question that you’ve done your homework to ensure it’s not processed in a shared facility/shared line with something else you’re allergic to. For example, when we challenged hummus with my daughter we ensured the hummus we brought wasn’t processed in a shared facility with nuts, her other allergen. We didn’t want cross contact risk even playing a factor.

Bring lots of activities for entertainment. If it’s for a child, I’ve found new toys/books and games always help because it holds attention longer. Having a favorite stuffed “friend” or their favorite soother is helpful too. But if you’re an adult, a good book and your favorite digital gadgets will probably suffice:) 

Bring safe snacks. If the challenge goes well, you may be there for several hours (and the tiny doses of food the doctor gives you likely won’t fill you up). We like to bring some of my daughter’s favorite snacks that are tried and true and we know are safe for her (another place you want to avoid bringing cross contact into the equation)! It’s an added bonus if you can bring foods that are free from the most common allergens (peanuts, tree nuts, fish, shellfish, wheat, egg, milk and soy). We figure it’s an allergist’s office so there are likely lots of other patients that sit in the same office with those allergies. On the same note, I bring disinfectant wipes in case the food spills so that I can clean it up properly for the next allergic patient. 

Bring your emergency medications. This may seem silly at first (hello, you’re at your allergists office)! but it’s so important. There’s always a small chance of a delayed reaction and if that happens on the way home, you want to have your epi pen and antihistamine at the ready.

Leave the siblings at home. If the food challenge is for your child, it’s best to leave their best buddy at home. Although it may be hard to find childcare for the better part of the day, it’s important to focus on why you’re there. Best case, you don’t have a reaction and it’s quality time with your babe. Worst case if a reaction does occur, you need to be able to focus on your child and follow the doctor’s protocol. And if you’re an adult, bring someone with you. That way if a reaction does occur you have someone by your side (for comfort and helping you get home)!

Set a course of action/next steps. Once the challenge is completed, make sure you talk to the doctor about next steps. If the challenge went great, what do you do about exposure moving forward? If it didn’t, is further testing/follow up required?

Hope these tips are helpful folks, I will say after we experienced one food challenge I felt so must better equipped for take on the second. Hopefully this will help you to be fully prepared for your first, if you haven’t learned the ropes yet.

Until next time,




Posted on March 29, 2016 and filed under Oral Food Challenge.