Food Allergy Treatment Center
Food allergies impact the lives of millions of children and their families. At Nationwide Children’s Hospital's Food Allergy Treatment Center, our team of experts understands how food allergies can affect so many aspects of daily living.
Our center provides all-inclusive and patient-specific care for children with suspected or confirmed food allergies. Our team offers:
- Comprehensive evaluation to establish or rule out a food allergy diagnosis
- Education regarding risks and avoidance strategies
- Management for children of all ages, including those starting school for the first time or adolescents transitioning to independent living
- Psychosocial support for every patient
We are the only center in central Ohio that provides high risk oral food challenges, which is the best way to help families truly understand their child’s individual risk for reaction. Treatment options, including oral immunotherapy and clinical research trials, are also available for interested families.
At the Nationwide Children’s Hospital Food Allergy Treatment Center, we recognize that food allergy management is NOT one size fits all. We work with each family to meet their individual needs and empower them to confidently manage their child’s food allergies.
Our Treatment Approach
At the Food Allergy Treatment Center, “treatment” means much more than giving medicine or immunotherapy. We firmly believe in providing families with evidence-based information to help each parent and child make decisions with the best information available.
We recognize each child is unique, and each family may adopt a different approach. Successful food allergen avoidance management is not one size fits all and requires the development of skills to help navigate our world with confidence and empowerment.
- Treatment starts with making sure we have the correct diagnosis and are avoiding the foods that pose risk for a reaction. Our team has seen the negative impact that misdiagnosis of food allergy can have on a family and will take the time to discuss how to properly diagnose food allergies.
- Treatment also includes providing education and helping families develop the necessary skills to manage their child’s food allergies on a daily basis. Confidence grows through experience and we treat a lack of experience through role playing, reviewing situations and proximity challenges for those concerned about casual exposures causing severe reactions.
- We treat anxiety through our multidisciplinary approach with psychologists, counselors, child life personnel and a dedicated recognition of how impactful this can be for each family.
- At every encounter, our team reviews the recognition and treatment of anaphylaxis, including hands on training with epinephrine autoinjector trainer devices (EpiPens.)
Diagnosing Food Allergies
Proper food allergy diagnosis is extremely important to identify a food that may cause reactions with future ingestion and to protect against unnecessary avoidance if allergy is not present.
Our team of medical experts will spend significant time reviewing a detailed history and listen to your concerns about your child’s symptoms.
What’s a Food Allergy?
A food allergy causes rapid onset and reproducible symptoms with each ingestion. Some children may have mild symptoms such as itching or skin rash. Others can experience life-threatening reactions such as anaphylaxis, which can cause progressive breathing difficulty, vomiting and passing out. The clinical history is the most important part of the evaluation for possible food allergy.
Eight foods cause more than 90% of all food allergies:
- Cow’s Milk
- Hen’s Egg
- Tree nuts
- Finned fish
Food allergy can potentially occur to any food, and we can evaluate for all suspected causes of a reaction. One of the aspects our medical team will focus on is the details surrounding the symptoms that occurred, timing of onset, duration and any treatment that was given. Food allergy reactions are reproducible, and a thorough history of other ingestion of the same or similar foods is very useful in diagnosing allergy.
Our experts are well versed in the many symptoms or other conditions that can mimic food allergy and help families not only understand when a food allergy is not present, but take time to explain why your child may be having certain symptoms.
Food Allergy Testing
Our center offers comprehensive testing with a team of nurses and medical professionals who have extensive experience working with children of all ages. The days of dozens of scary allergy tests being placed all at once are long gone. We will discuss options for testing with your family and decide what method is best for your child.
At the Food Allergy Treatment Center, we take time with every family to discuss how food allergy tests work, what they measure and how they are interpreted. We do not support unnecessary or excessive testing and understand both the downsides and benefits to using these tests.
Skin Prick Testing
Skin prick testing involves placing small drops of liquid allergen on the back or forearm, then gently scratching through the top layer to introduce the food allergen to allergy cells in the skin. This does not involve any needles or shots.
- If a food allergy is present, a small, localized, itchy bump and redness will develop.
- The results are available within 15 minutes. Our allergy experts will spend time reviewing what the results indicate and how to interpret them appropriately.
Blood testing can also help diagnose food allergy or determine if a child with a known food allergy may develop tolerance over time. Our center offers on site laboratory testing so families do not need to drive to another location or make a separate appointment.
- The results from blood tests generally return in 2-4 days and a member of our team will always call to discuss.
Oral Food Challenge
An oral food challenge is the most accurate test to determine if someone is allergic to certain foods. Our medical experts recognize the value in pursuing oral food challenges and have extensive experience with thousands of challenges conducted over the past 10 years.
Oral food challenges are useful to establish a diagnosis of food allergy when the history and/or testing are indeterminate and are also used to help confirm if tolerance has developed to a known food allergy. They are safe and very helpful to families, even if symptoms occur, as families learn that their child is truly allergic and also see what a reaction looks like, as well as how to properly treat. Our team of food allergy experts is always present and readily available throughout all challenges.
How Does an Oral Food Challenge Work?
- Members of the Food Allergy Treatment Center team will gradually feed a child measured amounts of the food that is suspected to cause an allergy.
- Allergy specialists will monitor the patient for any reactions that may occur over the next 3-4 hours.
- If the allergist sees an allergic reaction, they will treat accordingly. The team will then provide any prescriptions, education and support needed to make sure the patient and the patient’s family feel confident managing the allergy away from the clinic.
- If no symptoms occur, then children can safely incorporate that food into their diet.
Unfortunately, only about 20% of children with peanut, tree nut or seafood allergy will develop tolerance as they get older. They need to practice ongoing avoidance measures throughout life to avoid accidental ingestion. Some children with food allergies are at risk to have severe reactions even if they eat a very small amount. Oral immunotherapy is a protocol that can help build tolerance to small amounts of the food over time and reduce the risk for severe allergic reaction with trace exposures.
Our Center offers oral immunotherapy and will happily discuss with all families who are interested. We believe in shared decision making and will provide important information regarding what the protocol entails, risks associated with the treatment or missed doses, expected outcomes and goals of treatment.
Oral food challenges prior to starting oral immunotherapy are extremely valuable, as there are some children who are no longer allergic and can avoid oral immunotherapy all together. Others may not experience any reaction, or only a mild reaction after eating an amount of food that is well above trace amounts. For others, the oral food challenge can help guide dose adjustments with oral immunotherapy and allow for more personalized dosing and increased efficacy.
Meet Our Leadership
David Stukus, MD, is an associate professor of Pediatrics in the Division of Allergy and Immunology and director of the Food Allergy Treatment Center.
Support For Your Family
Our center recognizes the burden families face in trying to avoid accidental ingestion. Our team spends time with every family to help them understand their child’s individual risk of reaction from various exposures and scenarios. We understand how scary it can be for a parent to watch their child eat lunch next to another child who is eating their food allergen and work with them to balance the perceived risk of reaction with actual risk.
Anxiety is real and can dramatically impact how food allergy families function on a daily basis. Many families with high levels of anxiety choose to restrict their social activities, travel or dining at restaurants. Our team takes time with each family to address these concerns and identify areas where anxiety may shift from being useful (remembering to carry your child’s epinephrine device) to unhelpful (not flying on an airplane due to fear of a reaction from airborne exposure).
We have child life specialists who help during visits and food challenges as well as psychologists and counselors to help families develop long term strategies toward positively managing their child’s food allergies.
The Director of our Center, Dr. Stukus, wrote the first book specifically addressing the challenges adolescents with allergic conditions face during their transition to independent living. Our Center focuses on helping families transition through various situations.
Whether it’s sending your toddler to preschool, your child to summer camp or a teenager who is leaving home for college, we have structured programs to help families navigate these specific challenges. We recognize the stress these situations can cause and walk families through every step, including ways to communicate with necessary school personnel or other caregivers. We also feel it is very important to involve the child and teenager in this process. Confidence grows through practice and we will help every family practice and prepare for these important life changes.
While we enjoy every moment we spend with families and their children, we realize our medical team plays only a limited role in their life. Social support is an important part of the food allergy community. Whether it’s sharing allergen free recipes, discussing important issues such as epinephrine injector shortages, or just having support from another family who knows what it’s like to live with food allergies, our Center has developed a social program that families can elect to participate in. We can also help guide families towards reputable and trustworthy online resources.
Resources For Professionals
Quality Improvement Initiatives
Nationwide Children's Hospital is one of the leading pediatric academic institutions in Quality Improvement. The Food Allergy Treatment Center utilizes data to understand areas that can benefit from improvement and employs structured quality improvement methodology to demonstrate improvement in specific areas. This is a significant part of how we strive to deliver the best clinical care possible.
Recent quality improvement efforts helped us increase our capacity to offer oral food challenges, utilize educational resources for infants and toddlers with a new diagnosis of cow’s milk allergy and assess health literacy among caregivers.
Our medical experts participate in advocacy efforts outside of our clinical setting.
- Dr. Grayson serves on the Board of Directors for the Asthma and Allergy Foundation of America.
- Dr. Stukus is very active on social media, where he uses his @AllergyKidsDoc account to provide evidence based information and dispel myths and misconceptions.
- Our medical experts also helped pass legislation in Ohio allowing schools to stock epinephrine autoinjectors and albuterol to use on any student, not just those who have their own prescriptions.
- Our allergists also worked with the laboratory services at Nationwide Children's Hospital to eliminate the use of all food allergen blood panels, which are a leading cause of misdiagnosis of food allergy.
These are just a few examples of how our team is dedicated to improving the lives of all children with food allergies and allergic conditions, not just the ones we see in person.
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