Johns Hopkins All Children's Hospital

Food Allergy Clinic

Testing and treatment for children with food allergies

In the Food Allergy Clinic at Johns Hopkins All Children’s, we provide comprehensive care for children of all ages with suspected or confirmed food allergy. Our program is the first hospital clinic dedicated to pediatric food allergy in Florida.

Some of the most common food allergies in children are milk, egg, peanut, tree nuts (including walnut, pecan, almond, cashew, hazelnut and pistachio), wheat, soy, fish, shellfish and sesame seed. We treat children with a range of food allergy conditions due to these and other allergens.

Whether your child’s reaction was mild or severe, or due to a single or multiple foods, we will work with you and your children and guide you through the process of additional testing and treatment options.

Having a food allergy can be stressful for the child and the whole family. We also focus on patient and family education, including topics like how to read food labels, how to use emergency allergy medication such as injecting epinephrine — a medication that treats an acute allergic reaction — and how to manage a child’s allergy outside the home at school, daycare, camp or other places.

Conditions we treat

  • Food allergy and its related conditions, such as eczema and anaphylaxis
  • Food protein-induced enterocolitis syndrome (FPIES), or inflammation of the digestive tract that causes vomiting and diarrhea triggered by certain foods, usually milk, soy, rice or grains
  • Food protein-induced allergic proctocolitis (FPIAP), or inflammation of the rectum and colon that causes diarrhea or blood in stools triggered by certain foods, usually milk or soy
  • Food intolerance
  • Eosinophilic esophagitis (EOE)

Procedures we offer

  • Skin testing for food allergy
  • Blood test for evaluation of food specific Immunoglobulin E (IgE) levels and component resolved diagnosis (CRD)
  • Oral food challenge

What to expect

Your child’s first appointment will include a physical exam, and we will take a complete history, including any reactions they have experienced to foods, and review any past treatments or test results your child may have had. We will gather information about the type, timing and frequency of the reaction.

We will recommend additional testing as needed. Skin testing for food allergies takes about 15 minutes and may be done the same day if the patient is ready. We may also refer your child for a blood test.

Skin test

During a skin test (sometimes called a prick test), we apply to the child’s back or arm a set of devices coated with the known allergen extracts for which we want to test. The device has small prongs that will create minor scratches on the skin and allow the allergen extracts to penetrate. If your child has a type of food allergy known as “IgE-mediated reaction” a small wheal reaction likely will develop at the testing site and allow us to confirm the allergy.

Skin testing is usually a reliable method for food allergy diagnosis, with results available in 15 minutes. We will carefully select the allergen extracts for your child’s skin test depending on his or her history. Skin testing can be done during a regular clinic visit.

Blood test

Blood testing, now available for a wide range of food items, is used in conjunction with a skin test for food allergy evaluation. The blood test measures the immunoglobulin E (IgE) antibody specific to each food being created by your child’s immune system. Component resolved diagnosis (CRD) to some foods such as peanut, hazelnut, egg, and milk may be used in addition to IgE testing.

Oral food challenge

An oral food challenge is an elective test in which the patient slowly eats small amounts of food to confirm or rule out a suspected allergy. An oral food challenge will take three to four hours.

The family will bring the food their child is testing to the appointment. A week before your child’s oral food challenge, we will call you to confirm the foods we will test and the ingredients you should use.

On the day of the appointment, you will be required to bring two epinephrine autoinjectors with you, in case your child has a delayed reaction on the way home from your appointment. After taking your child’s vital signs, we will start by giving him or her a very small amount of the food you prepared for the test and monitor for a reaction. If your child does not have a reaction, we will increase the amount of food given every 15-20 minutes and continue to observe them for an hour after the last dose.

Completing an oral food challenge in a controlled environment allows us to monitor for and treat an allergic reaction to confirm foods your child does or does not need to avoid.

Schedule an Appointment

For more information about the Food Allergy Clinic or to make an appointment, please give us a call.

Read inspiring stories about our patients:

Meeting the Allergy Challenge

The list of foods on Samuel’s “can’t eat” list was long, but with the help of Panida Sriaroon, M.D., he’s been able to expand his diet, giving his family more peace of mind.

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