Pediatrician Dr. Julie Sweeney (@allergymom.md on IG) reflects on a recent oral food challenge her son faced and shares thoughts on what you can do to pave the way for a calm oral food challenge, or ‘Supervised Exposure’ as she would call it. Read on…
I recently made an oral food challenge (OFC) appointment for my son for lentils. Fortunately he’s all-in to see if he’s fully outgrown the allergy, or not.
But, the thought of ‘challenging’ a food that’s made you really sick in the past on purpose could be scary for a child, even terrifying.
And that name — oral food CHALLENGE — only adds to kids’ anxiety levels, layering on top of anxiety they may already be feeling about the whole process ahead of them because it communicates the idea that “Oh I could fail if I’m not able to eat it,” and makes them fearful of possible failure.
At a recent food allergy conference one of my favorite allergists explained he’s now calling OFC’s ‘Supervised Feedings’ instead of ‘Oral Food Challenges.’ Reframing an OFC to a ‘Supervised Feeding’ conveys that “Someone is watching me while I eat this, so we’ll see how it goes,” removing the fear of possible ‘failure.’
While I really like the name “Supervised Feeding” for babies and younger children, it might not work as well for older kids and teens. When I polled my Instagram followers for alternatives, here’s what they dreamed up:
- Supervised Exposure
- Supervised Food Trial
- Supervised Snacking
- And the fanciest was, Supervised Tasting
One mom even suggested saying something like, “We’re going to go see if your body’s ready for ‘X’ food yet.” And I love the word YET. There’s so much hope behind that single word.
My personal pick for older kids is “Supervised Exposure.”
Our oral food challenge or ‘Supervised Exposure’ to lentils went really well. Lentil soup was one of my son’s favorite foods and now he can eat it again. Next up for testing will be chickpeas, then almond. We’re encouraged, hopeful.
After many hours spent at the allergist, I want to share a few ‘Supervised Exposure’ tips while they’re still top of mind.
- Make sure you bring enough things to keep your child busy and for you to stay busy as well. The testing can go on for hours and those hours can pass very slowly when you count the minutes until the next dose and the next dose and so on. Distractions will keep your mind off the clock. My son worked on a hefty reading assignment (a great use of time!) and I caught up on paperwork (never a shortage of that when you run a pediatric practice.)
- If it’s ok with your allergist, bring extra food for your child. I had some Made Good bars and an Enjoy Life bar in my bag so when my son got hungry for a snack he had one of those. Nothing makes time crawl like the hungries!
- Make sure you have your two epinephrine auto-injectors with you when you head to the allergist’s office. You’ll want them close at hand when you leave the doctor’s office after the ‘Supervised Exposure.’ You’ll be confident as you leave the doctor’s office that you’re prepared in case something happens post-food challenge — which can happen, but is very rare.
I recently learned that a Swiss-based company, Atanis Biotech, has developed a test called a mast cell activation (MAT) test that shows promise for accurately confirming the presence of peanut allergy, and even multiple food allergies at some point down the road.
Wouldn’t it be amazing to no longer have to undergo oral food challenges to prove whether you’re allergic to a food, or not? To just be able to have a blood sample taken and learn with 100% certainty if you’re allergic, or not?
Before you get too excited, the test has many, many hurdles to clear before it’s brought to market and it could take years, but learning about developments like this gives me such hope for the future of food allergy diagnosis. (And until then, we have the oral food challenge.)
For more background, take a look at the published research on it and Allergic Living’s recent coverage of the development.
Stay hopeful. I am.
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Pediatrician Dr. Julie Sweeney is passionate about caring for the whole child. |
| About the Author: Dr. Julie is board certified by The American Board of Pediatrics and is a fellow of the American Academy of Pediatrics with an extensive background in pediatric food allergy care. She has completed specialized training in nutrition and food allergy through FARE and the Academy of Pediatric Integrative Medicine. She’s also an expert allergy mom who has navigated allergies with 3 kids for almost 15 years. In her practice, she helps families better understand their child’s diagnosis, while adding an integrative medicine approach to their child’s care — from nutrition, to emotions, to lifestyle — empowering the entire family to thrive. Follow her on Instagram (@allergymom.md) | |
Images: @allergymom.md