Conducting an Oral Food Challenge: An Update to the 2009 Adverse Reactions to Foods Committee Work Group Report

J. Andrew Bird, Stephanie Leonard, Marion Groetch, Amal Assa'ad, Antonella Cianferoni, April Clark, Maria Crain, Tracy Fausnight, David Fleischer, Todd Green, Matthew Greenhawt, Linda Herbert, Bruce J. Lanser, Irene Mikhail, Shahzad Mustafa, Sally Noone, Christopher Parrish, Pooja Varshney, Berber Vlieg-Boerstra, Michael C. YoungScott Sicherer, Anna Nowak-Wegrzyn

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114 Scopus citations


Oral food challenges are an integral part of an allergist's practice and are used to evaluate the presence or absence of allergic reactivity to foods. A work group within the Adverse Reactions to Foods Committee of the American Academy of Allergy, Asthma & Immunology was formed to update a previously published oral food challenge report. The intention of this document was to supplement the previous publication with additional focus on safety, treatment of IgE-mediated allergic reactions, guidance for challenges in infants and adults, psychosocial considerations for children and families participating in an oral food challenge, specific guidance for baked milk or baked egg challenges, masking agents and validated blinding recipes for common food allergens, and recommendations for conducting and interpreting challenges in patients with suspected food protein–induced enterocolitis syndrome. Tables and figures within the report and an extensive online appendix detail age-specific portion sizes, appropriate timing for antihistamine discontinuation, serum and skin test result interpretation, written consents, and instructional handouts that may be used in clinical practice.

Original languageEnglish
Pages (from-to)75-90.e17
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number1
StatePublished - Jan 2020


  • Anaphylaxis
  • Baked egg
  • Baked milk
  • Double-blind placebo-controlled food challenge
  • Egg
  • Food allergy
  • Food protein–induced enterocolitis syndrome
  • Milk
  • Oral food challenge
  • Peanut
  • Tree nut
  • Wheat


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