Compliance and co-operation from the child is vital. It is worth discussing with the parents beforehand. The most difficult age is 4-6yrs.
Parents should bring the required food if the hospital cannot provide it, and they have no problem doing so.
Oral food challenges that need to be done as a day case procedure require access to full resuscitation equipment. Staff conducting and supervising oral food challenges should be competent in doing so. The ability to recognize and treat allergic reactions is essential to patient safety.
Food: Straight cow’s milk
Setting: Hospital/Paediatric Day Unit
- For Children under 1 year use regular infant formula, starting with 1ml, 5ml, 10ml, 25,ml, 50ml.
- For children over 1 year use full fat cow’s milk: disguise the taste using some of the child’s regular milk if needed.
- For children over 5 yrs add an extra dose i.e 1ml, 5ml, 10ml, 25,ml, 50ml, 100ml.
- Marvel a dried milk product is useful to use if the child cannot tolerate the taste of full fat milk. It is also used when conducting double blind placebo controlled challenges, the protein content is the same as regular cows milk.
- The same principals apply for a soya milk challenge.
- Give the child incremental doses every 15-20 minutes.
- Children must be observed for 2 hrs after completion of the last dose
Outcome 1: If the oral food challenge is negative cow’s milk must be introduced into the diet at least 2-3 times a week.
Outcome 2: If the oral food challenge is positive cows milk must be strictly avoided, and arrange appropriate follow up as per care pathway.