The staff at New England Food Allergy Treatment Center is here to answer your questions. Below are common questions and answers that surface from patients and families across all ages.
We always advise that you reach out to us directly for medical advice or if you have any further questions. Don’t hesitate to contact us!
1) How long will the OIT process take?
The first day procedure will take about 5-6 hours. The time to reach the top maintenance is about 10-12 months, depending on any symptoms during the build-up dosing.
2) What age does my child need to be to participate?
We are enrolling OIT patients at 12 months and older. Sublingual immunotherapy can begin as young as age 4-5 years old. A consultation will be required to evaluate patient readiness.
3) What foods are available for OIT?
Peanut, Sesame, Tree nuts, Milk, Egg, Wheat, and Chickpea. We are open to discussing all your food allergies and potential treatment options.
4) Can OIT and SLIT be done for more than 1 food at a time?
Yes, we offer Multi-Food OIT and SLIT. We may combine 2 foods for OIT and several foods concurrently for SLIT. Each immunotherapy treatment plan is individualized to the patient.
5) Should routine allergy medications be stopped before the first day procedure?
No, it is not necessary. We only advise to hold antihistamines prior to skin testing and oral food challenges. Please call the clinic if you have specific questions.
6) What is the timeline for the months after the first day?
Exactly how it goes, depends on each individual child/adult. Patients will come in every two weeks for buildup-dosing. If they are having any symptoms, we may not increase the dose, or even decrease until better tolerated.
7) What are the most common symptoms during build-up?
By far, gastrointestinal symptoms are most common. Upset stomach, nausea and less frequently, vomiting. Also, patients may complain of an itchy throat after their dose.
8) How often can the dose be increased?
The interval between dose increases is a minimum of fourteen days. Patients should have a minimum of 12 doses prior to increasing to the next dose.
9) What should be eaten before dosing?
It is important to consume a largely carbohydrate meal before doses are given, either at the Center or at home. Suggestions of foods to eat/bring on the morning of your initial day of desensitization include bagels, waffles, pancakes, cereal, and breakfast sandwiches.
10) What time of day should home doses be given?
It does not matter what time of day the peanut dose is given as long as it is taken with a meal and there is a 2 hour observation period without exertion after the dose is given.
11) What precautions should be taken around dosing?
Avoiding exercise or hot showers for 2 hours after dosing is imperative. Strenuous exercise just prior to dose should also be avoided. Increased heart rate and body temperature from exercise, heat exposure, or fevers can lead to reactions. Allergic reactions can more commonly occur under any of these circumstances.
12) How many days can doses be skipped at home and resumed safely afterwards?
Doses can be held at home for up to 1 or 2 days and then resumed. If doses need to be held any longer than 2 consecutive days, please contact the office for advice on how to proceed. If you miss more than 2 doses over 2 weeks, we may need to reschedule your updose appointment to ensure you have had enough doses prior to increasing.
13) What about home dosing on the day of the office visit for dose increase?
The dose should not be given at home that day. NEVER increase the dose on your own at home.
14) If there is a reaction at home, what should I do?
Treat the reaction the same way you would any food reaction; antihistamine if there are mild symptoms (slight rash, itchy mouth or throat, a stomach ache). Give epinephrine (Epi-Pen or Auvi-Q) if there are other symptoms of anaphylaxis, (or above symptoms appear to be progressing. Call us after the appropriate immediate intervention. We will give instructions on future dosing.
15) What if I need additional doses and I am out of town?
Call as soon as you know you need more. You must be able to tell us what the current dose is. The patient is responsible for shipping fees. This fee cannot be charged to your insurance.
16) What is the goal of this process?
The goal of therapy is to desensitize patients to the allergen they are allergic to. That means creating a safety net if there is an accidental ingestion. Safety is our number one concern. We have shown how oral immunotherapy improves quality of life in those treated patients and their families.
17) What happens when I get to maintenance?
Every OIT food has a defined maintenance dose that will continue to be taken daily at home.
18) What is the follow up schedule when the maintenance food is being eaten?
When the maintenance dose has been reached, there should be follow up appointments scheduled at 6 months, 12 months than yearly.
19) What is the success rate in desensitizing patients?
We have been able to desensitize greater than 85% to 90% of patients who enroll in our programs.
20) What is the cost for the procedure?
Most commercial insurances cover the procedures for desensitization. Patients are responsible for co-pays and deductibles just as they are at any physician’s office.