Food challenge - would you do it?

[ellegoat]

My dd (now 21 mos) began eating eggs a little after she turned one. Since I'm allergic to eggs, I watched her reaction to eggs very closely, and since she didn't seem to be adversely affected and likes them, she began eating eggs quite frequently.

Well, at around 18 mos she got the blood test for allergies (they were trying to find out if allergies was behind her slow weight gain) and she was borderline positive to eggs. The allergist and gastoenterologist strongly recommended doing an egg food challenge, where we go to the clinic one morning and they give her controlled does of powdered egg up to two eggs. The whole process will take 4 hours.

But being a toddler, getting her to eat, especially in the morning, is just a huge challenge. She frequently refuses to eat, even favorite foods, and I'm not anticipating it being easy to get her to eat on command in a strange place with a bunch of new people watching her every bite.

We discontinued giving her eggs when her blood test results came back, and in the 3 months since she's been egg-free, I really haven't noticed a difference in either her weight gain or her eczema, which they thought it might relate to as well. Since she ate eggs with no problems for months not that long ago, I'm thinking the end result of the food challenge is going to be that she's not allergic, even though the docs say the blood test is really good (as in, "more than 50% predictive" of allergy).

Am I crazy for not wanting to do the food challenge? The docs were really against doing it at home, in the form of giving her a bit of eggs to eat. What do you think?

[changingseasons]

Were they aware that she'd been eating eggs prior to the test? Because that IS a food challenge. You've already done a food challenge at home. I'm pretty surprised that they would push for an in-office challenge if it was just a borderline positive.

The other thing is- eggs are one of the foods that has a really different protein structure cooked vs raw. My DD had huge positives to both egg white and egg yolk on her SPT and will get full body hives with just contact of raw egg, but can eat 2 whole hard-boiled (well cooked) eggs straight, no problem. (Like you, we were eating eggs before getting the test results back, because all other egg tests for her had been negative in the past.) The allergist said that eating eggs cooked in baked goods was fine (because it's usually a really small amount, AND it's well cooked) although he was surprised that she was ok with eating them hardboiled after seeing the test results.

That said, if she is actually allergic, you will get a much more obvious reaction after being off them for a while and then challenging. So if your allergy is anaphylactic (and you're worried that hers might be too), and in-office challenge is probably a good idea. Or you could have them do a skin test or another blood test to confirm the positive.