Food allergy can affect almost every part of family life — school, nursery, birthday parties, restaurants, holidays, travel and even everyday meals.
- American Hospital Dubai Science Park, Dubai, UAE
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Food allergy can affect almost every part of family life — school, nursery, birthday parties, restaurants, holidays, travel and even everyday meals.
Food allergy can affect almost every part of family life — school, nursery, birthday parties, restaurants, holidays, travel and even everyday meals.
For some children, Oral Immunotherapy (OIT), also known as food allergy desensitisation, may help increase the amount of an allergenic food they can tolerate before developing a reaction.
Treatment is carefully planned for each child and supervised by an experienced allergy team.
Oral Immunotherapy involves giving a child a very small, carefully measured amount of the food they are allergic to.
The amount is gradually increased over time according to an individual treatment programme.
The aim is to increase the child’s reaction threshold so that a larger amount of the food would be required to cause an allergic reaction.
This is known as desensitisation.
For many families, the main goal is to provide an additional level of protection against accidental exposure and reduce some of the anxiety associated with living with food allergy.
Peanut is one of the most extensively studied foods for Oral Immunotherapy.
Peanut OIT aims to increase the amount of peanut a child can tolerate, helping provide greater protection should accidental exposure occur.
For selected children with persistent IgE-mediated cow’s milk allergy, milk desensitisation may be considered.
Before starting treatment, we assess your child’s allergy history, testing, previous reactions and whether they tolerate any forms of baked or heated milk.
Treatment is personalised according to the child’s individual allergy.
Egg OIT may be considered for selected children with persistent IgE-mediated egg allergy.
Some children with egg allergy can tolerate extensively heated or baked egg while reacting to less-cooked forms. We therefore assess your child’s individual pattern of allergy carefully before deciding whether OIT is appropriate.
Oral Immunotherapy may also be considered for selected children with tree nut allergy.
Tree nut allergy can be complex because a child may be allergic to one tree nut but tolerate others.
We therefore assess each relevant nut individually rather than assuming that an allergy to one tree nut means allergy to every tree nut.
Your child’s treatment programme will depend on their individual test results, clinical history and treatment goals. Food allergy care is a journey. Families are supported at every stage.
Sesame allergy can cause significant allergic reactions and may persist into later childhood.
For appropriately selected children, sesame Oral Immunotherapy may be considered with the aim of increasing the amount of sesame that can be tolerated.
As with all OIT programmes, treatment is individualised and requires regular dosing and specialist follow-up.
Treatment generally involves three stages.
1. Starting Dose
Treatment begins with a small amount of the allergenic food under medical supervision.
2. Up-Dosing
The dose is gradually increased.
Dose increases are carried out according to clinical response.
Between appointments, your child continues their prescribed dose at home.
3. Maintenance
Once the agreed maintenance dose has been reached, your child continues taking that amount regularly.
The maintenance plan and longer-term goals are discussed individually with each family.
There is no single treatment timeline
Some children progress more quickly than others.
OIT is not a race. Our priority is finding a treatment schedule that is safe and manageable for your child and family.
Yes. Because OIT involves eating a food to which your child is allergic, allergic reactions can occur during treatment.
Families undertaking OIT must know how to recognise and manage allergic reactions.
Your child should continue to have access to their prescribed adrenaline/epinephrine auto-injector like EpiPen or Jext and personalised allergy emergency plan.
Illness can sometimes affect how a child responds to their usual OIT dose.
You will receive specific instructions about when to continue, reduce, delay or withhold a dose.
Do not increase or alter your child’s dose independently
Missing a dose occasionally can happen.
The appropriate action depends on how many doses have been missed and where your child is in their treatment programme.
Do not double the next dose.
If several doses have been missed, contact the allergy team before restarting.
We provide families with a clear missed-dose plan as part of their treatment programme.
Exercise and other factors can sometimes increase the likelihood of a reaction around an OIT dose.
The exact precautions may vary according to your child’s treatment programme.
Yes.
Even after successful desensitisation, children undergoing OIT should continue carrying their prescribed emergency medication unless their allergy specialist specifically advises otherwise.
OIT increases the reaction threshold but does not mean that allergic reactions can no longer happen. The exact precautions may vary according to your child’s treatment programme.
Not necessarily.
For some children, the treatment goal is protection from accidental exposure rather than unrestricted eating.
Other children may eventually be able to incorporate larger amounts of the food into their diet.
Your allergy specialist will explain exactly what your child may eat outside their prescribed maintenance dose.
Families should never experiment with larger amounts at home without medical guidance.
Some children are allergic to several foods.
Depending on the child’s allergy profile, age, previous reactions and treatment goals, we may discuss treatment of more than one food.
This requires careful planning.
In some children, treating one allergen at a time may be preferable. In selected circumstances, a different approach may be considered.
We discuss the advantages, limitations and practical commitment with each family before treatment.
Eosinophilic oesophagitis, or EoE, is an inflammatory condition affecting the oesophagus.
Children with known EoE or symptoms that could suggest EoE require specialist assessment before OIT.
Persistent gastrointestinal symptoms during OIT should always be discussed with the treating allergy team.
Usually yes, with appropriate planning.
Discuss longer trips with your allergy team in advance.
OIT can offer important benefits, but it also requires commitment from both the child and family.
OIT should be a shared and informed decision between your family and your child’s allergy specialist.
No two children with food allergy are the same.
Before starting treatment, we confirm the diagnosis, review your child’s previous reactions and allergy investigations, assess any associated conditions such as asthma, and discuss your family’s goals.
We then decide together whether OIT is an appropriate option for your child.
This page provides general educational information and does not replace personalised medical advice.
Oral Immunotherapy should only be undertaken with appropriate specialist medical supervision.
Parents should never attempt to introduce, increase or desensitise a child to a known food allergen at home without a treatment plan provided by an appropriately qualified allergy specialist.
If a child develops symptoms of a severe allergic reaction, follow their personalised emergency allergy plan, administer adrenaline/epinephrine when indicated and seek emergency medical assistance.
OIT is better described as desensitisation rather than a guaranteed cure.
Successful treatment can increase the amount of food a child can tolerate before reacting.
However, protection may depend on continuing a regular maintenance dose.
Long-term permanent tolerance cannot be guaranteed.
The goal depends on the child and family.
For many families, the most important goal is increasing protection from small accidental exposures.
For others, treatment may eventually provide greater dietary freedom.
Before starting OIT, we discuss what you would like treatment to achieve and whether those expectations are realistic for your child.
Not necessarily.
An Oral Food Challenge may be recommended when we need to:
Confirm whether an allergy is still present
Establish how much food your child can currently tolerate
Determine whether the allergy has naturally resolved
Better understand your child’s reaction threshold
For children with a very clear history of ongoing food allergy, a challenge may not always be necessary.
We make this decision individually.
Assessment may include:
A detailed allergy history
Review of previous reactions
Skin prick testing
Specific IgE blood testing
Component allergy testing when appropriate
Assessment of asthma and eczema
Oral Food Challenge when clinically indicated
We do not make treatment decisions based on a single allergy test result alone.
Possibly.
A previous severe reaction does not automatically prevent a child from being considered for OIT.
However, these children require careful assessment before treatment.
We review your child’s previous reactions, allergy results, asthma control and other risk factors before discussing whether OIT is appropriate.
Children with asthma may be able to undergo OIT, but their asthma needs to be well controlled.
Uncontrolled asthma can increase the risk associated with allergic reactions.
Please tell us if your child develops increased coughing, wheezing, breathlessness, night-time symptoms or requires their reliever inhaler more frequently
