Oral Food & Medication Challenges

  • If you or your child are scheduled for an oral food or medication challenge, please read this information carefully.

    As part of the process, please ensure the following:

    1. Bring the food being challenged: You must bring the specific food that will be tested. This ensures that we can safely and accurately administer the challenge.

    2. Bring your EpiPen: For your safety, it is mandatory that you bring an EpiPen (or another epinephrine injector) to the appointment. If you do not bring it, the challenge will not be performed, and we will have to reschedule.

    3. Stop all antihistamines the Friday before your challenge (Zyrtec, cetirizine, Allegra, fexofenadine, Claritin, loratadine, Clarinex, desloratadine, Xyzal, levocetirizine, Benadryl, diphenhydramine, Atarax, hydroxyzine, etc)

    Oral Food Challenge Process: During the challenge, we will administer small, controlled doses of the food you are testing, gradually increasing the amount. Throughout the procedure, you will be closely monitored by our medical staff for any signs of a reaction. The challenge typically takes about 2-3 hours, depending on the progression and your response. Our priority is your safety, so rest assured that we will be fully prepared to handle any emergencies should they arise.

    Please be aware that a $100 no-show fee will be charged if you miss the appointment without prior notice. No-show fees for Medicaid patients are waived, but we will still ask for advanced notice if you need to cancel or schedule.

  • If you or your child is scheduled for a baked muffin (egg or milk) or French toast challenge, it is important to follow directions carefully. Please call our office with any questions or concerns.

    For baked egg recipe, please click here.

    For baked milk recipe, please click here.

    For French toast recipe, please click here.

  • We are able to challenge most foods, if needed. If you are already scheduled for an oral challenge, please see below regarding what specific type or brand of food to bring for the appointment.

    Nuts:

    Almond:

    • Butter: Barney Almond Butter

    • Whole nut: Blue Diamond (12 whole almonds, salted or plain; no spices)

    • Almond Milk: Unsweetened Silk Milk (5.5 cups total for adults)

    Cashew: 

    • Butter: Maisie Jane’s Cashew Butter

    • Whole nut: 12 whole cashews

    Hazelnut:

    • Nutella: 4 tablespoons (¼ cup)

    • Whole hazelnuts

    Peanut:

    • Bamba (infant): 40 Bamba sticks

    • Peanut butter: Smooth Jif, Skippy, or Smuckers peanut butter

    • Powder: PB2 peanut powder (infants should bring 3 fruit purees)

    • Reeses Cups: 2 large cups

    • Reeses Pieces: 88 Reeses Pieces 

    • Whole nut: 16 whole peanuts

    Pecan:

    • Butter: Guidry Farms Pecan Butter

    • Whole nut: 25 pecan halves

    Pistachio:

    • Whole nut: Wonderful Pistachio (~20 nuts)

    Walnut:

    • Butter: Crazy Go Nuts Walnut Butter

    • Whole nut: 12 walnut halves

    Dairy:

    Milk:

    • Cheese Cubes: Sargento Mild Cheddar Cheese Cubes (8)

    • Whole milk: Fresh pasteurized cow’s milk

    • Yogurt: Yogurt (non-Greek, 1 cup)

    • Baked muffins: Baked as noted in recipe

    Egg:

    • Baked muffins: Baked as noted in recipe

    • Lightly cooked: French toast per recipe

    • Lightly cooked: 1 scrambled egg

    Seafood:

    • Fish: 1.5 ounces of cooked fish (unseasoned or salt only)

    • Shellfish: 3 ounces of cooked shellfish

    • For shrimp, recommend 1 ring of pre-thawed cocktail shrimp.

    Miscellaneous Foods:

    • Banana: 2 whole bananas

    • Beef: One 3-4 ounce cooked hamburger patty

    • Coconut: Goya Coconut Milk (6-8 ounces)

    • Oatmeal: Quaker Oats Heart Healthy Old Fashioned Oats, 1 cup prepared

    • Sesame Seed: 1 tablespoon tahini

    • Soy: Silk Unsweetened Soy Milk (8 ounces)

    • Wheat: Cream of wheat, ¼ cup prepared