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Pearls and pitfalls of food challenges in infants

Matthew Greenhawt

    Allergy and Asthma Proceedings
    |December 25, 2018
    PubMed

    Insights

    Performing open oral food challenges (OFCs) in infants aged 4–12 months is safe and feasible, according to recent trials. This review guides allergists on office setup for infant OFC, addressing comfort and experience gaps.

    Area of Science:

    • Allergy and Immunology
    • Pediatric Medicine

    Background:

    • Oral food challenges (OFCs) are the gold standard for diagnosing food allergies.
    • Open OFCs are increasingly used in clinical practice.
    • New guidelines recommend early peanut introduction, necessitating OFCs in infants.

    Purpose of the Study:

    • To review the essential features of performing OFCs in infants aged 4–12 months.
    • To guide allergists in office setup and procedures for infant OFCs.
    • To address the need for increased provider comfort and experience with infant OFCs.

    Main Methods:

    • Review of recent randomized controlled clinical trials on infant OFCs.
    • Analysis of safety and feasibility data for OFCs in young infants.
    • Guidance on practical aspects of office-based infant OFC.

    Main Results:

    • Recent trials demonstrate that OFCs are safe and feasible in infants aged 4–12 months.
    • There is a need to enhance allergist comfort and experience with infant OFCs.
    • Practical guidance is provided for conducting infant OFCs in an office setting.

    Conclusions:

    • Office-based open oral food challenges are a practical approach for infant food allergy diagnosis.
    • Further training and experience are needed for allergists performing OFCs in infants.
    • This review provides a framework for allergists to confidently perform infant OFCs.

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