In order to optimize the best test results you need to be in good health for the challenge. If you (or your child) are experiencing significant rash, fever or cold symptoms or worsening asthma the challenge may need to be rescheduled. If in doubt, please call and discuss with the nurse.

  • For patients under the age of 18, we request that a parent/legal guardian be present for the duration of the Oral Challenge appointment.  If this is not feasible, please complete the Oral Challenge Consent form.  If this form is not available at the time of the appointment, we will ask you to reschedule.
  • If you or your child is taking regular daily medications to control respiratory or skin problems – DO NOT STOP THEM. Never stop taking medications for asthma.
  • Oral Challenges can only be performed if the patient is stable. There should not be any active respiratory or skin symptoms which are poorly controlled with medications.
  • If respiratory or skin symptoms are flaring up, please call as we may need to re-schedule your oral challenge.

If you or your child is having a food oral challenge, please make sure that you or your child’s appetite is not suppressed by recently eating a big meal before the food challenge.

You may bring clear liquids (Jell-O, apple juice, fruit juices without pulp, iced tea, Gatorade or popsicles) to ingest during the challenge. The patient will be permitted to eat approximately 1 hour after the last challenge dose is ingested.  If the patient is breastfed this should be continued as normal.

Please come to the appointment with activities to keep busy for approximately 4 hours.

How is the test done and how long will it take?     This test requires that you ingest increasing amounts of the challenge item over several hours.  During this time the nursing staff will be monitor you for any signs of allergic reaction.  Before you begin, a preliminary lung function test or peak flow meter reading may be performed along with vital signs and visual evaluation in order to establish your current health.  Next, you will start the challenge by ingesting a very small amount of the item.  A timer will be set for holding period. This process is repeated throughout the challenge.

The test may take up to 4 hours. If the patient is a child; it is best if you can arrange to spend this appointment time just with the child being tested.  Space may be limited and your child will benefit from your individual attention.

Are there any long-term effects?    There should not be any long-term effects from this test.  In the short term, the test may cause you to develop hives/rash, wheeze, chest tightness, shortness of breath, abdominal pain or nausea/vomiting.  Potentially life-threatening reactions could occur.  Should this occur, the test will be halted and the doctors and staff will evaluate and treat you.  If necessary, Epinephrine, antihistamines, and oral steroids may be part of this treatment.

 You will also need to bring a quantity of the challenge item with you to the appointment.

We are only able to challenge one item per day. Generally you should bring a “serving size” of the food to be challenged to the appointment.

What food should I bring? We always suggest a “serving size” portion of the food challenged. Here are some common foods we challenge and the amounts to bring can serve as a guide for other foods.

Peanut butter: at least 2 tablespoons
Reese’s Pieces: 84 pieces (two 6 ounce bags)
Reese’s Peanut Butter cups: 4 cups
Peanuts: at least 30 peanuts
Bamba: 2 packages
Cow milk
At least 8 ounces
Baked cow’s milk
Scrambled eggs: 2 eggs scrambled
French toast: 2 slices, 1 egg per slice
Baked egg
Tree nuts
Almonds: at least 20
Walnut: at least 20
Pecans: at least 20
Cashews: at least 20
Pistachios: at least 44
At least 1 ounce (2 tablespoons) of tahini (sesame seed spread found in ethnic food section of grocery store).
“Sesame Snaps” at least 8 candies

*See recipes for baked egg and baked milk to prepare for these challenges.