Pediatric Food Challenges

Based on the history and allergy test results your doctor has suggested that a food challenge be performed as part of your child's evaluation at National Jewish Health. The purpose of a food challenge is to identify if your child is allergic to a specific food and how much of the food it may take to cause a reaction.

How do you get ready for the test?

Please follow these directions when getting ready for this test.

  • One parent will need to be present during the food challenge. Because space is limited, it is important not to bring other children and adults to the food challenge.
  • The parent attending the food challenge should plan to eat outside the Food Challenge Room and may be away for a short period of time arranged with the nurse in the room.
  • Your child's doctor may ask you to bring in a specific food for the food challenge. Please bring the food the morning of the test. You may also be asked to bring a favorite food in which to place the food to be challenged.
  • Please do not bring other foods into the food challenge room. Your child's food allergies may be different from the other children being challenged. This will help keep the room safe for all the children having food challenges.
  • Usually the child eats only the food being provided during the food challenge unless the doses are small and the child is too hungry to continue without being fed. Please discuss this with your nurse and do not feed your child other foods during the food challenge.
  • Plan to bring small activities your child enjoys (games, puzzles, coloring books). We will also have some available.
  • The following medicines might affect the results of the food challenge and will need to be stopped before the testing is done unless your doctor tells you otherwise. If the medicine is not stopped before the food challenge we may not be able to complete the challenge. All antihistamines will affect the results of some of these tests and need to be stopped before the testing is done. If you have any concerns about stopping antihistamines please check with your child's doctor before you stop the medicine. If the medicine is not stopped before the test we may not be able to perform the test.
  • Stop these antihistamines for the length of time listed before your appointment at National Jewish Health.
  • Stop these oral antihistamines for 5 days before your appointment:
Claritin® (loratadine)
Allegra® (fexofenadine)
Clarinex® (desloratadine)
  • Stop these oral antihistmanines for 3-4 days before your appointment:
Actifed®, Dimetapp® (brompheniramine)
AtaraxÒ, VistarilÒ (hydroxyzine)
Benadryl® (diphenhydramine)
Chlortrimeton® (chlorpheniramine)
Phenergan® (promethazine)
Tavist®, Antihist® (clemastine)
Zyrtec® (cetirizine)
Actifed®, Aller-Chlor®, BromfedÒ, Drixoral®, Dura-tab®, Novafed-A®, ine-D®, Trinalin® (Combination medicines)
  • If your child is taking an oral antihistamine that is not listed stop the medicine for 3-4 days before your appointment. If you are not sure if the medicine you are taking is an antihistamine ask your doctor.
  • Some antidepressants can also act as an antihistamine. Let your doctor know if your child is on any antidepressants before the food challenge. Do not stop the antidepressant without discussing it with your doctor.
  • Stop these medicines the night before your appointment:

Singulair® (montelukast)
AccolateÒ (zafirlukast)

  • Stop these medicines the morning of your appointment:

Zyflo® (zileuton)
Tagamet® (cimetadine)
Zantac® (ranitidine)
Pepcid® (famotidine)
Axid® (nizatidine)

  • Continue to give your child all other medicines as you usually do.
  • If your child is sick, please call to cancel the food challenge. This includes cold symptoms, diarrhea or a stomach ache, a body rash or atopic dermatitis flare. The food challenge results may be hard to interpret if these are present. If you have any questions, please call to speak with a nurse. The number to call is 303-398-1355.
  • Your child should be hungry when you arrive for the food challenge. He/she should have a very light breakfast or no breakfast.
  • Please check in at the Front Desk in Pediatrics at the time your child's test is scheduled.

What is done during the test?

Your child will be checked in and thoroughly examined prior to starting the food challenge. Your child will begin the food challenge by eating a small amount of the suspected food. If the first dose is tolerated your child will be fed gradually increasing amounts of the food every 30 to 60 minutes until a normal meal-sized portion is eaten or the challenge is stopped because of symptoms or a reaction. Your child will be monitored closely during the food challenge by the nursing staff. Your doctor or the healthcare provider asked to fill in for your doctor will be available to provide evaluation or treatment in case of any symptoms.

The food challenge may be an open, hidden or a double blind placebo controlled food challenge. During an open food challenge your child will know which food is being challenged and how much of the food is given. During a hidden food challenge the food will be hidden in another food your child likes. This is helpful for a child who may not want to eat the food being challenged. For example, if egg is the food being challenged, it may be hidden in chocolate pudding. Although during a hidden food challenge your child will not know which or how much of the food is being given, the nursing staff does. During a Double Blind Placebo Controlled Food Challenge the food being challenged is hidden from the person being challenged and the healthcare provider giving the food. The healthcare provider preparing the challenge food is aware of which and how much food is being challenged. This type of challenge may be used to help determine if symptoms are caused by eating the food or by worrying about eating the food.

Once the food challenge is done your child's doctor will discuss the results with you, answer your questions, and make recommendations.

How long will the test take?

A food challenge usually takes from 6-8 hours, but can take even longer if the child has a reaction. You should plan to spend the entire day at National Jewish. If a child is having the food challenge, one parent will need to be present for the duration of the food challenge. Typically, only one food is challenged each day.

How do you get to your test?

Your child's food challenge will be scheduled in the Pediatric Food Challenge Room in the Pediatric area. This is located on the second floor of the Gaulter Building. Check in at the Front Desk in Pediatrics at the time your test is scheduled. If you have questions please call 303.398.1355.

This information has been approved by Dan Atkins, MD (February 2010).

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