What happens after my appointment?
Your child has successfully completed the hospital-based part of the challenge or feed!
The challenge has either been:
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Positive: had symptoms to the food and must avoid the foods now.
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Negative: no reaction to the food. The food must be reintroduced.
They won't be able to do strenuous activities that afternoon/ evening such as sport or dance, and we suggest a quiet evening.
They should be fit for school the next day
Potential delayed reactions
Some children unfortunately may have a delayed reaction which can occur 6 to 48 hours after the challenge. The signs of an allergic reaction may be:
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Nausea and vomiting
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Diarrhea
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Tummy ache
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Worsening of their eczema
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Running nose and eyes
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Swelling of face eyes hands and feet
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Pale and floppy
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Generalised blotchy rash
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Hives anywhere on the body
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Wheezing and coughing
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Itching and swelling in the mouth
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Tight throat knew line difficulty in breathing or swallowing
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Weakness or floppiness
If your child reacted
If your child has reacted to the food during the challenge, they should avoid strenuous play or sport for the rest of the day, as this could bring on a delayed reaction. Normal toddler activities are ok, but try to avoid situations where they may become over-excited. Very hot baths, fizzy drinks, and large meals have been connected to a return of allergy symptoms and should be avoided straight after the challenge. They should be fit for school the next day.
Before you go home you will be given an allergy action plan if you don't already have one, with clear instructions on how to treat an allergic reaction if needed. We will also contact your GP to let them know about the food challenge.
Please contact the Paediatric Assessment Unit at the Royal Devon University Healthcare NHS Foundation Trust if your child has a return of allergic symptoms overnight or is not well enough to go to school the next day on 01392 404729. Please tell them what the food challenge your child has had and the full nature of the reaction.
If a reaction occurs
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Follow your child's treatment plan.
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See your GP if it is an increase in eczema or a mild reaction.
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Attend your local A&E department if the reaction is severe or includes difficulty in breathing.
If your child did not react
If your child has not reacted to the supervised feed, they should not eat the food for another two days (48 hours) in case of mild delayed symptoms. Delayed symptoms after a negative supervised feed are very different and much less severe than the delayed symptoms that can be experienced after a positive food challenge, which is why our advice is different.
Things that can happen include tummy pain, diarrhoea, or a flare of eczema. Delayed symptoms are not very common; most children are fine if they do not react on the ward. There are no other special precautions and your child can undertake normal activities and diet.
Please contact Bramble Paediatric Ambulatory unit or the paediatric allergy and respiratory nurse specialists if you think that your child has experienced a delayed reaction after a negative food challenge.
After 48 hours it is important to introduce the food into your child's diet. You should aim for at least 2-3 portions each week.
We will give you personalised information on how to continue with your child's diet in the Bramble Day Case Unit before you are discharged.
How do I make comments about my treatment?
If you would like to comment about your experience of our services and you would like to speak to someone other than staff caring for you, please contact the patient advice and liaison service bracket (PALS) on 013924 02093. You can almost you can also e-mail pals at rde-tr.PALS@nhs.net
The PALS team will listen to your concerns comments suggestions or queries and are often able to solve problems on behalf of patients.
If you have any questions or concerns please contact the Children's Allergy Team at Royal Devon University Healthcare NHS Foundation Trust:
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Allergy Clinic Team secretaries on 01392 406633
-
Bramble Paediatric Ambulatory unit: 01392 402281
-
Out of hours, please contact NHS 111 service
Allergy nurses email address: rduh.paediatricallergy-eastern@nhs.net
Your child has successfully completed the hospital-based part of the drug challenge!
The challenge has either been:
-
Positive: had symptoms to the drug and must avoid the drug now.
-
Negative: no reaction to the drug.
They won't be able to do strenuous activities that afternoon/ evening such as sport or dance, and we suggest a quiet evening.
They should be fit for school the next day
No reaction during the challenge
Potential delayed reactions:
Some children unfortunately may have a delayed reaction which can occur 6 to 48 hours after the challenge. The signs of an allergic reaction may be:
-
Nausea and vomiting
-
Diarrhoea
-
Tummy ache
-
Worsening of their eczema
-
Running nose and eyes
-
Swelling of face eyes hands and feet
-
Pale and floppy
-
Generalised blotchy rash
-
Hives anywhere on the body
-
Wheezing and coughing
-
Itching and swelling in the mouth
-
Tight throat knew line difficulty in breathing or swallowing
-
Weakness or floppiness
-
If your child suffers from any of the symptoms listed above, please stop the drug and treat it with an antihistamine, such as cetirizine or loratadine.
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Follow your child's treatment plan if they have one, and/or see your GP if required.
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It would be helpful to take a photo of any rash, if possible.
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Please contact respiratory clinical nurse specialists on 01392 402682 to report the reaction as soon as possible.
Signs of a more severe allergic reaction
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If your child has redness and peeling of the skin, particularly the mouth or around the eyes, or a rash similar to multiple cold sores stop the drug and seek urgent medical help
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Other signs:
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Swelling of the face, eyes, hands or feet
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Coughing or wheezing
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Breathlessness
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Itching and swelling in the mouth
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Tight throat
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Difficulty in breathing or swallowing
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Weakness, floppiness or collapse
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If your child experiences any of the above symptoms:
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Call 999 for an ambulance or go to your nearest A and E immediately
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If your child has an adrenaline autoinjector (EpiPen, Jext, Emerade) for this type of allergic reaction, follow your child's emergency plan
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Do not give your child any more of the drug
If your child has had an antibiotic challenge:
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To complete your antibiotic challenge, it is important to continue a short course of the antibiotic after leaving the hospital.
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This information will be provided after your challenge by clinic staff.
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Please follow the information above in order to look for signs of a delayed allergic reaction. If your child shows any signs or symptoms of a delayed reaction, follow the corresponding advice and do not give any further doses of the antibiotic.
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Once your child has finished the course of antibiotics, please call the clinical nurse specialists on 01392 402682 to let us know that your child has been well whilst taking the medication.
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We will then write to your GP to confirm that your child is not allergic to this particular antibiotic and that it can be safely prescribed if needed in the future.
If your child reacted
If your child has reacted to the drug during the challenge, they should avoid strenuous play or sport for the rest of the day, as this could bring on a delayed reaction. Normal toddler activities are ok, but try to avoid situations where they may become over-excited. Very hot baths, fizzy drinks, and large meals have been connected to a return of allergy symptoms and should be avoided straight after the challenge. They should be fit for school the next day.
Before you go home you will be given an allergy action plan if you don't already have one, with clear instructions on how to treat an allergic reaction if needed. We will also contact your GP to let them know about the food challenge.
Please contact the Paediatric Assessment Unit at the Royal Devon and Exeter NHS Foundation Trust if your child has a return of allergic symptoms overnight or is not well enough to go to school the next day on 01392 404729. Please tell them what drug challenge your child has had and the full nature of the reaction.
How do I make comments about my treatment?
If you would like to comment about your experience of our services and you would like to speak to someone other than staff caring for you, please contact the patient advice and liaison service bracket (PALS) on 013924 02093. You can almost you can also e-mail pals at rde-tr.PALS@nhs.net
The PALS team will listen to your concerns comments suggestions or queries and are often able to solve problems on behalf of patients.
If you have any questions or concerns please contact the Children's Allergy Team at Royal Devon University Healthcare NHS Foundation Trust:
-
Allergy Clinic Team secretaries on 01392 406633
-
Bramble Paediatric Ambulatory unit: 01392 402281
-
Out of hours, please contact NHS 111 service
Allergy nurses email address: rduh.paediatricallergy-eastern@nhs.net