Information for patients 

These guidelines will help you get ready for your upcoming food challenge. Please read them carefully so you know what to expect. This information is for patients of all ages (adults and children), but it is general. You may get more instructions from your provider. If you have any questions about the food challenge or need to reschedule your appointment, please call our office at 503-494-8531. 

What is a food challenge? 

An oral (by mouth) food challenge is a medical test that shows how your body reacts to certain foods. It is the best way for your provider to tell if you have food allergies. It can also help explain other symptoms and test results. Another thing a food challenge can do is show whether you have outgrown food allergies you had in the past.  

During your food challenge, you will eat “doses” of food that your provider thinks you may be allergic to. Your medical team will watch while you eat the food. This lets them look for reactions, treat them (if needed) and diagnose you. 

How to get ready for a food challenge 

Your provider will let you know exactly what you need to do to get ready. It will vary, depending on your needs. In general, the guidelines are: 

1. Eating and drinking: Do NOT have anything to eat or drink for 4 hours before your food challenge. For example, if your food challenge appointment starts at 11:30 a.m., do not eat anything past 7:30 a.m. Children up to the age of 3 can have a small meal 2 hours before their food challenge.  

2. Antihistamines: You will need to stop taking antihistamines a few days before your food challenge. It is different for each person. Your provider will tell you when to stop (it can be anywhere from 3 to 10 days). 

3. Other medications: Your provider will let you know if you need to stop taking any of your medications before your food challenge.  

4. Inhalers: Keep using all of your asthma steroid preventive inhalers and nasal steroid sprays (fluticasone, budesonide, beclomethasone, flunisolide, mometasone, ciclesonide, triamcinolone) as usual.   

5. Rescue inhalers: Do NOT use your rescue inhaler (albuterol, xopenex) for preventive reasons (such as before exercise) in the 8 hours leading up to your food challenge.  

6. Asthma and allergic reactions: If you need to use a rescue inhaler, an antihistamine or an EpiPen® to stop an allergic reaction or asthma attack, PLEASE USE IT. Then, call us at 503-494-8531 to discuss your symptoms. We may need to postpone the food challenge.   

What to bring to the food challenge 

You will need to bring your own food to your food challenge. Your provider will give you a list of food to bring. You should also bring: 

1. EpiPens®, Auvi-Q® or other epinephrine autoinjectors, if you have them  

2. Activities to keep you (or your child) busy while we monitor you (books, tablets, homework, coloring, toys, etc.). 

3. Pack more than 1 form of the food on their challenge list. For example, if they are testing for a cow’s milk allergy, bring plain milk, cheese and yogurt. 

How long does a food challenge take? 

Most of the time it takes around 4 hours. It can take 3-6 hours. This includes time spent waiting in the clinic after the test while we monitor you and watch for reactions.  

Note: If your child has a history of food protein-induced enterocolitis syndrome (FPIES), plan to stay at the clinic for up to 6 hours.  

What if I have an allergic reaction during the food challenge? 

If you have an allergic reaction, we will treat your symptoms and make sure you are safe before sending you home. If we need to use epinephrine to treat you, you may need to stay for a few hours. If the reaction is severe, you may need to go to the emergency room.  

What if I am not feeling well on the day of my food challenge? 

Please call us if: 

• You are sick the week of the challenge — such as, if you have a fever or known infection. 

• You are having bad asthma, eczema, or nasal allergy symptoms the week of the challenge — such as, if you frequently need to use your rescue inhaler, are blowing your nose a lot or have an eczema flare.  

Depending on your symptoms and the reasons for them, we may need to reschedule your food challenge.  

What if my child is doing the food challenge?  

If your child is the one doing the food challenge, it is a good idea to explain it to them in a way that they can understand. You may also need to do some extra things to help them feel more comfortable. What you say or do will depend on their age, but here are some ideas: 

• Tell them that they are taking a special food test at the provider’s office to find out if they are allergic to anything. 

• Make sure they know that a provider or nurse will be there to keep them safe.  

• Let them know that they can bring games, toys or a special stuffed animal. 

• Offer a special prize at the end of the test. 

• Bring a favorite plate, cup or spoon that may make it easier for them to try a new food.