Rate of Food Introduction after a Negative Oral Food Challenge in the Pediatric Population

Abstract

Oral food challenges (OFCs) are performed to diagnose food allergy persistence or outgrowth. This study evaluated the rate of food introduction following a negative OFC and reasons for failure to introduce challenged foods at home. An anonymous survey was distributed to parents of children with food allergy during follow-up visits. Thirty-three respondents reported having had 75 OFCs. Data collected included challenged food, result of the OFC, the frequency of food introduction, and reasons for failure to incorporate the challenged food into the diet on a regular basis. Of the 75 OFCs, 52 were negative OFCs. After completion of 52 negative OFCs, 4 foods (8%) were not added to the diet, 10 foods (19%) are included in the diet a few times a year, 9 foods (17%) are included monthly, 17 foods (32%) are included weekly, and 9 foods (17%) are included daily. 27% of the foods were never introduced or seldom included in the diet after a negative OFC. Reasons included dislike (5), fear (3), and the food not being part of the diet (3). Three did not provide reasons. The foods most avoided were tree nuts, peanut, and chickpea. After a negative OFC, about a quarter of the foods were still being avoided for various reasons. Post-challenge counseling and dietary guidance to address potential barriers may be beneficial to increase rates of food introduction following negative OFCs.