Why is a
Challenge performed?

A challenge procedure definitively determines if your child is or isn’t allergic to the particular food or challenge. Your doctor may have ordered the challenge test for a variety of reasons, most commonly because:

Your child never eaten the food, but have had a skin test which is positive to the food

Your child has previously had an allergic reaction to the food, but now the skin test is lower and they may have outgrown their allergy

Your child may be allergic to fresh milk or whole egg, but potentially tolerant to small amounts of baked egg or baked milk in a cake/muffin

How is a
Challenge performed?

How is a challenge performed?

Your child will have their challenge performed under medical supervision in a clinic setting. This usually involves your child coming in for approximately 3-4 hours either in the morning (8.30am-12.30pm) or afternoon (12.30-4.00pm).

Your child will generally be looked after by an specialist allergy nurse, and initially a very small amount of the food (e.g. 1/8 of a teaspoon of peanut butter) will given. If this is tolerated, then the dose is gradually increased every 15-20 minutes until a full serve (e.g. 2 teaspoons of peanut butter) is given

What are the possible
Outcomes of a Challenge?

There are two usual outcomes, and that is

  • Your child has an allergic reaction – in which case usually antihistamine (e.g. Zyrtec) will be given to make your child feel better, or
  • Your child is tolerant to a full serve – in which case your child will then continue eating the food on a daily basis for the next 7 days. After 7 days, a nurse will contact you (to confirm that no reactions has occurred at home) to confirm that your child remains tolerant to the food.

How safe
Is a Challenge?

Very safe. We are very careful with performing our challenge procedure, initially through careful selection. We reduce the chances of a severe reaction occurring by ensuring your child is well at the time of the challenge, and has had no troublesome asthma.

As the challenge is conducted through slow administration of initially small quantities of the food or antibiotic, majority of allergic reactions (90-95%) are mild, consisting of hives, lip swelling, abdominal pain.

If your child has an allergic reaction, the chances of anaphylaxis (difficulties breathing, throat tightness, persistent coughing) are low, typically between 5-10%. If anaphylaxis does occur, majority will require only a single dose of an adrenaline injection.

What happen when my child has been
Deemed to passed a Challenge?

We will write a letter to your referring doctor to inform them that your child has passed the food or antibiotic challenge. If your child has passed a food challenge test, we recommend that they now incorporate the food into the diet as part of the regular diet, typically 2-3 times per week or whatever is practical.

Regular ingestion of the food may help ensure that tolerance is maintained and that the body “remembers” that the food is OK.

What to bring to
Your appointment

  • Bring your Medicare Card
  • Bring your GP Referral (If it has expired)
  • Bring any “special” cup or bowl that your child likes.
  • Bring a couple of suitable activities for your child, remembering that a challenge can take up to 4 hours eg. Playing cards, iPad, puzzles, colouring books.
  • Bring along a change of clothes for your child and yourself (just in case).
  • As space is limited in the clinic, we can only accommodate one parent. Please do make separate arrangements for other children.
  • Before the appointment, if your child is hungry, please let them only have a light, non-fatty meal. This will help prevent prolonged absorption and a delayed allergic reaction during the challenge.
  • Please ensure your child has no significant exercise/running activities during or after the challenge, as this may increase the risk of a serious allergic reaction.

Food Challenge

Please bring along the a) challenge-food, and b) something to mix the challenge-food with if desired. The tables on the next page will provide you with a guide.

Please ensure that the food used to mix the challenge-food with is something which your child is normally able to tolerate.

Example of challenge food to bring/make.


For an antibiotic or medication challenge

Please bring along the relevant antibiotic or medication.

Your specialist will have already provided you with the script for the antibiotic or medication at the time of the consultation

Please ensure that the script is filled with a pharmacist on the week of the challenge.

Moisturisers and Creams, and Allergy Testing

Do not apply moisturisers or creams to you child’s back or forearms on the day of the visit (this is where a skin test will be performed). Please continue using your creams on other parts of the body if required.

Antihistamines and Allergy Testing

Do not give your child antihistamines for 5 days before the visit as this can interfere with allergy test results. This includes:

  • Claratyne, Zyrtec, Aerius
  • Phenergan, Polarmine
  • Vallergan
  • Dimetapp, Demazin, or any other cough mixtures.

Important Information

Please ensure that your child is well with no viral infection.

If your child is unwell with a virus (runny nose, cough, fevers) this increases the chance of a severe allergic reaction occurring.

Action: Please immediately call MACCS on 03 9345 6888 to discuss and possibly reschedule the challenge

If your child has asthma, please ensure that this is well controlled.

If your child is unwell with asthma, this also increases the likelihood of a severe allergic reaction occurring.

We consider asthma to be poorly controlled if your child has symptoms of asthma (coughing, wheezing, chest tightness) and needing Ventolin 2 times/week or more leading up to the challenge.

Action: Please arrange to see your GP for an asthma review and immediately call MACCS on 03 9345 6888

Please ensure that your child has not had any antihistamines for at least 5 days before the challenge.

If your child has taken an antihistamine within 5 days, this may potentially mask a true allergic reaction occurring.

Please do not discontinue your child’s usual asthma preventers (Flixotide/Seretide) and nasal sprays.

Action: Please immediately call MACCS on 03 9345 6888 to discuss and possibly reschedule the challenge

Other services

Skin Prick Test

Find out how to get prepared for your Allergy Challenge appointment.