Pediatric Food Challenges

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This information was reviewed and approved by Bruce J. Lanser, MD, MPH (11/1/2018).

What is a food challenge?

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. 

  • 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.

  • 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.

  • Parents may bring food (but may be asked to eat it in a particular area) or buy food in the cafeteria.

  • Please bring your child’s Epi-pen®, Auvi-Q® or Adrenaclick® (epinephrine) if you have one. This can be used in case your child has a delayed reaction after you leave National Jewish Health.

  • Plan to bring small activities your child enjoys (games, puzzles, coloring books). We will also have some available.

  • 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.

 

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)

        • Zyrtec® (cetirizine)

      • Stop these oral antihistamines for 3 days before your appointment:

        • Actifed®, Dimetapp®   (brompheniramine)

        • Atarax®, Vistaril® (hydroxyzine)

        • Benadryl® (diphenhydramine)

        • Chlortrimeton® (chlorpheniramine)

        • Phenergan® (promethazine)

        • Tavist®, Antihist® (clemastine)

        • Astelin®, Astepro®, Dymista® (nasal sprays)

        • Actifed®, Aller-Chlor®, Bromfed®, Drixoral®, Dura-tab®, Novafed-A®, ine-D®, Trinalin® (Combination medicines)

      • If your child is taking an antihistamine that is not listed,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)

      • Accolate® (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.

 

What is done during the food challenge?

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 15 to 30 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 will be available to provide evaluation or treatment in case of any symptoms. 

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 single food challenge usually takes from 4-6 hours, but can take 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. Sometimes more than one food may be challenged in a day, but this will be up to your child’s doctor.

 

How do you get to your food challenge?

Your child’s food challenge will be scheduled in the Pediatric Food Challenge Room or on the Pediatric Care Unit 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.

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