Skin testing is a very common and reliable test to determine your child’s allergies. Using small amounts of solution that contain different allergens, your child's doctor will either inject under the skin or apply the allergens on the surface of the skin with a small prick and assess the reaction or lack of reaction to determine whether your child is allergic to the allergen.

Allergen extracts are used for skin prick testing.

Every patient receives a food allergy action plan to help guide the patient and family in daily life.

Dietary avoidance is a treatment option for food allergies. The six most commonly implicated dietary antigens in the United States are milk, soy, wheat, eggs, fish (and shellfish) and peanuts (and tree nuts). Elemental formulas, as pictured here, are sometimes used to supplement your child’s diet to maintain healthy growth.

Graded oral food challenge is a test to find out whether a person is allergic to a food. The food challenge is done in Allergy Clinic or the hospital. The challenge starts with a very small amount of the suspected food allergen and is gradually increased in dose during the visit. Food challenges are done if it is unclear whether a patient is allergic to the food in question, or when a previous food allergy seems to be resolving.

Oral immunotherapy (OIT) is a process of building up tolerance to a food your child is allergic to. The goal of OIT is to decrease your child’s sensitivity to the food allergen. By desensitizing to the food allergen, it may lower the risk of life-threatening allergic reactions. The process is also known as desensitization.

There are promising developments in the management of food allergy, including the recent approval by the FDA of omalizumab (brand name Xolair) for the prevention of food allergy reactions in people one year of age and older. Omalizumab blocks immunoglobulin E (IgE), a protein that triggers allergic reactions, including severe ones like anaphylaxis. Omalizumab binds with allergy antibodies in the blood, reducing the risk of allergic reactions for all food allergens. This medication is injected every 2-4 weeks. Treatment options for your child can be discussed with your allergist.

Graded oral food challenges and oral immunotherapy are conducted in a controlled environment. Treatment of any adverse reactions may include emergency medications such as albuterol, prednisone, Benadryl and/or Epi-Pen.

Food allergen exposure can result in adverse reactions, which may require use of emergency medications and devices, such as the Epi-Pen (injectable epinephrine), Auvi-Q (injectable epinephrine), and Neffy (nose spray epinephrine). Patients and families are instructed in how to use emergency medications and devices.

Cincinnati Children’s is a Center of Excellence in the FARE Clinical Network, a nationwide network of leading research and clinical care facilities.