Oral food challenge or feeding test is a medical procedure in which a food/allergen is eaten in small increments, increasing in amount, while supervised by a medical professional. Our food challenges start at 9am and end between 12pm or 1pm. Before each challenge, I always take pictures of Mina’s face, belly, back and shoulders so that I can compare if she does get any reactions. Sometimes the reactions are so subtle or she might have an existing rash from dry skin, so it’s good to have “before” pictures.
Nut Allergy Oral Challenges
Mina had her first food allergy test with peanuts. Peanut allergies tend to be the most serious as there is a high likelihood of not growing out of it and having the allergy into adulthood. Her blood test came back negative, but she had a small reaction during the skin test, so the allergist recommended testing peanuts first, hoping the skin test was a false positive.
We arrived at 9am and the technician gave Mina a very small amount of peanut that was ground up – an incredibly tiny amount, like a few small crumbs on a spoon. Then we waited for 30 minutes, monitoring Mina to see if she had any skin reactions on her face, belly and back. She didn’t have any reactions so the technician doubled the amount (still tiny crumbs) and we watched her again. She was given greater amounts of ground peanut every 30 minutes until 12pm. Luckily Mina didn’t have any reactions and it’s confirmed that she’s not allergic! We were so relieved and happy. The allergist recommended we continue to expose Mina to peanuts at least 3 times a week, giving her about 2-3 teaspoons a day.
We came back once a week to test almonds, cashews and hazelnuts. We were so relieved that she passed all of those oral challenges in the office. We continued giving her those nuts at home, but interestingly, she sometimes would react to almond and cashew at random times – weeks/months later. It’s always just a few small pink dots around her mouth, nothing else thankfully, but it happens randomly. We continue to give her all of her various nuts throughout the week to make sure she gets exposed.
Dairy Allergy Oral Challenge
Next we tested dairy, which is done in phases. The first dairy test is in the baked form, like one or two cups of milk in banana bread. The second test is in cooked form, like in a pancake cooked on the stove top. The third test is cheese, then yogurt, then regular milk. Mina passed the baked and cooked forms of dairy. The allergist recommended testing cheese a few months later to give her body time to get acclimated to dairy in the cooked form. Once enough time passes, we’ll try cheese.
Egg Allergy Oral Challenge
In the meantime, we decided to test her egg allergy. Similar to dairy, the first test is in baked form, then cooked in a pancake, then scrambled. We tried egg in banana bread. Mina tried a tiny crumb, the first oral challenge, but unfortunately she had a small reaction on her chest – pinkish/reddish marks – so the technician gave her Benadryl to be safe and we stopped the challenge. Luckily, Mina didn’t have any other reactions and her temperament was great, so I think the marks on her chest was her body just processing the egg. Regardless, the fact that she reacted to such a tiny amount isn’t the best sign – truly tiny considering there were 2 eggs in the entire loaf of bread and she literally ate 1 crumb of it. We’ll revisit egg in about 4-6 months.
You can read about Mina’s severe allergic reaction to eggs here and her diagnosis after meeting with the allergist here.
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