Will Oral Food Challenges or Accidental Ingestions Make Your Child's Food Allergy Worse?

 

If your child accidentally eats the food they avoid, will their food allergy last longer? What about purposely eating the food during an in-office food challenge? Have you avoided in-office food challenges because you’re afraid a reaction will make the allergy worse? A recently published study can put your mind at ease.

What the study was about

Researchers followed a group of 512 infants allergic to milk and egg. These babies also had a strong likelihood for peanut allergy. The researchers wanted to know what would happen if the children ate a small amount of allergen. Would this have an impact on their food allergy skin tests and blood tests?

What the study showed

The study included two groups of children. Some had oral food challenges (OFCs) that exposed them to their allergen. Some accidentally ate the food. Researchers looked at these children’s “before” and “after” skin and blood test results.

The results: These small exposures to allergens did not appear to make the allergy worse. There were no major differences in IgE levels or skin prick wheal sizes after oral food challenges. The same was true after children accidentally ate a small amount of milk, egg or peanut.

However, the researchers noted an important point about the study. The study only looked at short exposures to the food allergen, not repeated exposures.

Understanding the food allergy tests used in the study

The study used skin prick tests (SPT) and blood tests to evaluate the children’s food allergies. These tests detect the presence of specific immunoglobulin E (IgE) towards a specific food.

For skin prick tests, a drop of allergen is placed onto the skin surface. Then the skin is pricked so that the allergen goes into the top layer of the skin. If specific IgE antibody to the allergen is present, you’ll see an itchy bump and surrounding redness. The bump and redness is known as a wheal and flare.

IgE blood tests measure levels of specific IgE in the blood.

An oral food challenge in a medical setting is the “gold standard” of food allergy diagnosis. The patient eats small, but increasing, amounts of the suspect food to see if a reaction happens.

The study was published in the December 21, 2015 edition of Journal of Allergy and Clinical Immunology: In Practice.

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Comments (8)

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Paula Tarpley (Lucy) posted:

I hate that my insurance doesn't cover the allergy testing or the food challenge. Which leaves me with no choice but to do home challenges. This is very scary for me! What else can be done? 

 

Hi Paula, hopefully you find an allergist that you like and trust. Be upfront with the Doctor about the insurance issues and your concerns. Some allergists - not all - will allow patients to come and sit in the waiting room while the food is ingested. I hope you find one that you can work with. The other thing is, the allergy tests run about $1,500 depending on how many foods you're running. You may find that the cost is worth it?

I'm hoping to hear something back! Praying they can come up with something different that my insurance will pay for. I can go to an allergist and pay my co-pay but when they want to start the testing, that's where my insurance stops! It ridiculous and I'm so upset about this.

I know doctors can around it, some will and some won't. Hopefully I have one that will and can!

Thank you all for your support! I don't have family or friends so it's difficult to deal with all by yourself. 

I can't even wrap my head around an insurance that won't cover allergy stuff Allergies are such a widespread condition that can lead to time off work, etc. Hopefully the doctor has some good guidance for what you can do. 

No, I can't insurance because this is the insurance through my husbands work. There is no way I'm going to be able to do a food challenge at home. I'm way too frightened of what could happen but what else is one to do when you know that at some point you have to know?! 

Talked with doctor today (left message) and asked if there is a way around it. 

They wouldn't even pay for the skin or blood allergy test. It's crazy! Our insurance is amazing and we've had 14 years. Never had to use the allergy part until my daughter and had no idea that it wasn't covered.

That is very scary. It's important to do oral food challenges in a medically supervised setting with immediate availability of medical support/intervention in the event of a reaction.

Your insurance won't cover any type of allergy testing? Neither skin or blood testing?

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