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Why should your child
Undergo a Challenge?

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.

What are the
Possible outcomes of a Challenge?

There are two usual outcomes, and that is

  • Your child is tolerant to a full serve – 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 have occurred at home) to confirm that your child remains tolerant to the food or
  • Your child has an allergic reaction – in which case usually antihistamine (e.g. Zyrtec) will be given to make your child feel better.

How is a
Challenge Procedure performed?

Your child will attend the Challenge Clinic for approximately 4-5 hours, either in the morning (8:30am) or afternoon (12:30pm).

Your child will be looked after by a specialist allergy nurse, with your specialist doctor in attendance on the day.

Initially, a very small amount of the food (e.g. 1/8 of a teaspoon of peanut butter) will be given. If this is tolerated, then the dose is gradually increased every 15-20 minutes until a full serve (e.g. 2 teaspoons) is
reached

Is the
Challenge procedure safe?

YES. A Challenge procedure is offered following a very careful selection process.

The chances of a severe reaction occurring are reduced by ensuring your child is well at the time of the challenge, and if they have asthma that it is well controlled.

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, the majority will require only a single dose of an adrenaline injection.

What happens when
My child has been deemed to have passed a Challenge?

We will write a letter to your referring doctor to inform them that your child has passed the food or medication Challenge.

If your child has passed a food Challenge test, we recommend that they then incorporate the food 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

Preparation for your Allergy Challenge Appointment

Things to
Bring on the day.

  • Bring your Medicare card
  • Bring your GP referral
  • Bring any “special” cup or bowl that your child likes
  • Bring a suitable activity for your child, remembering that a challenge can take up to 5 hours
  • Bring along a change of clothes for your child and yourself in the event your child vomits
  • As space is limited in the clinic, we can only accommodate one parent. Please make separate child-care 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.

What food to
Bring for a food challenge.

Please bring along the

  • 2 serves of the food that caused the reaction.
  • A carrier food to mix with the serve of food to make the food more palatable for your child if they do not enjoy the taste.

Example of challenge food to bring/make.

Important Information

01.
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

02.
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

03.
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 ensure your child continues using their usual asthma preventers (e.g. Flixotide/Seretide) and nasal steroid sprays (Nasonex/Avamys)

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