Sneak Peek at a Food Allergy Challenge

Cupcakes? Check.
Story books? Check.
Movies on the tablet? Check.
Epi-Pen? Check.
Bravery? Check.

These were the essentials for getting ready for my daughter’s food allergy challenge this spring. She’s three now, and she’s had a severe egg allergy since she was a baby. When she was a nursing infant, sometimes after a feeding, she’d start clawing at her neck and she would get hives around her mouth, but I couldn’t figure out what I was eating that caused the problem. Then, when she was a little older and we started solids, she broke out in hives when she had muffins or other foods with eggs in them. So, we got her tested to make sure our guess of eggs was the culprit (it was), and they sent us home with a prescription for an epinephrine auto-injector and advised us to carefully make sure that she avoided eating any eggs. More than just not eating straight scrambled eggs for breakfast, she needed to avoid any foods with egg in them, ranging from mayonnaise to cake.

Food Challenge

At her last visit to the allergist, she had both a blood test and a skin test that showed positive progress toward outgrowing her allergy. Her doctors recommended doing an oral food challenge, a medical test in which she would eat measured doses of food with the allergen in a monitored setting. Doctors would be on hand in case things went poorly. Best case scenario, she’d be able to eat baked eggs (bring on the cake!). Worst case scenario, she’d have a full blown anaphylactic reaction. That would mean she could have rash, itching, swelling, trouble breathing, and of course, the ultimate food allergy parent nightmare: anaphylaxis can end in death. You know going in that this is EXTREMELY unlikely or they wouldn’t have you do the test in the first place. Still, when you have to sign something saying you understand that’s your child’s death is a risk of the test, it doesn’t feel very good.

With all that in mind, it felt kind of crazy packing up in the morning to on purpose go feed my child the food that we’d been so carefully avoiding for two years. But, that’s what we did. Her appointment was scheduled early in the morning. We went before she’d eaten breakfast, so that she’d be hungry and eager to eat. For a baked egg challenge, the doctors were very clever and used cupcakes as the food to test with. My daughter LOVES “pupcakes” as she calls them (check out my favorite egg-free cake recipe here) and was looking forward to going to the doctor to eat pupcakes for months leading up to the big day.

The hospital provided a special recipe with just the right ratio of eggs per serving. It was my job to bake the cupcakes and bring at least half a dozen along. I had initially been told that she would have to eat four whole cupcakes in two hours, which I thought was going to be impossible for my rather small toddler to do. But, when we got there, it turned out she only needed to eat one and a half cupcakes, the rest was “just in case.”

When we arrived, the doctors did an initial exam to make sure that she was healthy, since you can’t have had any kind of cold or sickness within two weeks prior or they won’t do the test. And, they made note of any red marks or skin rashes so that they wouldn’t be confused later, thinking that she was having a reaction. After that, one of the doctors brought her about a quarter of a cupcake. She was so hungry that she stuffed it in her mouth in one bite and promptly asked for more. She was a little grumpy that she didn’t get to have it right away. The doctor stayed with us for about 15 minutes, watching and waiting to make sure that she was OK. The doctor checked her over again and then got her another slightly larger serving of cupcake. Since she’d had no serious reaction, a medical assistant hung out with us instead of the doctor, and the doctors came in intermittently to see how she was doing.

In all, she had four servings, and got to eat 1 ½ cupcakes. We were there for about four hours. We read stories, she drew pictures, and then finally I caved, and we watched movies. She made it through Frozen and Tinkerbell, and just as we’d started a second round of Frozen, the doctors (God bless them for sparing me an extra Frozen!) came to say that she was in the clear. Throughout the monitored time, she had complained that her tongue hurt and her ears were itchy. But, her breathing was good and the symptoms went away on their own without any medical intervention. So, they thought that she would be able to tolerate baked egg on a regular basis. We’d have to feed it to her a minimum of three times per week to start systematically desensitizing her to eggs. And, we’d have to stick to their recommended recipe for at least a month before branching out into other baked egg recipes. I’d say she’s a pretty lucky little girl – she gets to have cupcakes for breakfast at least three times a week, on doctor’s orders! Her brother and sister are more than a little jealous.

It's a hard life she lives, eating cookies and cake on doctor's orders.
It’s a hard life she lives, eating cookies and cake on doctor’s orders.

We’ll go back in the fall to do another food challenge, this time with eggs cooked on the stove top. For whatever reason, cooked eggs tend to be more allergenic than baked eggs, so they take the testing one step at a time, and they want six months in between the baked egg challenge and the stove top cooked egg challenge. Once again, those doctors are pretty clever, and she’ll be tested using French toast. I have to admit, I’m kind of hoping they’ll tell us she has to have French Toast three times a week after that – it’s one of my favorite breakfast treats, and I just might need to make a little extra so we can both enjoy it!

If you or your child ever needs to go through a food allergy challenge in the future, I hope your experience goes as positively as mine did!

Laura is a mom of three who works full-time from home as a Development Director for a children’s charity. Laura grew up in Maryland, spent her 20s living in Southern California and South Carolina, and has spent her 30s and now 40s in Iowa, moving to Iowa City in 2010. Laura loves dancing, reading, baking, and music. She and her husband Ryan started dating in college (gasp – over 20 years ago!) and they have been sharing life’s adventures ever since. Their biggest adventure is, of course, parenthood. With three kids, the action is non-stop - which is just the way Laura likes it.


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