Traditional treatment for food allergy means strictly avoiding foods that someone is allergic to and making sure to be prepared to treat any accidental exposures with an epinephrine rescue medication and an emergency action plan. Recently, multiple treatment options for food allergy have become more common. While there is still no cure for food allergies, treatment options like oral immunotherapy (OIT) allow patients to actively manage their food allergies and decrease the risk of severe reactions and needing epinephrine.
Starting OIT or other food allergy therapies early (ideally before age 3-4) may also help increase the chances of sustained desensitization and potentially even outgrowing a food allergy, but treatments for food allergy can be done at any age. Increasingly, guidelines suggest that offering therapy for food allergies instead of just strict allergen avoidance can be helpful.
At Lurie Children’s, we offer a number of food allergy treatment options, and our specialists would be happy to discuss which may be right for your child and family.
Services
An overview of the services our team currently provides:
Oral Immunotherapy (OIT)
- Involves ingestion of small amounts of food allergen daily with incremental increases to induce temporary tolerance.
- Raises the threshold of food protein needed to be ingested to trigger an allergic reaction and minimizes the risk of severe reactions and anaphylaxis over time.
- Requires frequent office visits for up-dosing and daily consumption at home as well as strict activity restrictions following the dose to minimize risk of side effects
- Allows patients to incorporate some amount of the food allergen into their diet if desired
- Currently, we offer OIT for egg, peanut, and cashew
Sublingual Immunotherapy (SLIT)
- Involves daily doses of allergy drops under the tongue
- Requires nurse visits for build-up with daily dosing continued at home
- Typically does not lead to incorporating eating the food allergen in the patient’s diet
- Protects against accidental exposures to the food allergen with less severe reactions and increases the amount of food allergen that needs to be consumed to have a clinical reaction
- Can be done for multiple foods
Biologic Therapy: Omalizumab (Xolair®)
- Only FDA-approved food allergy treatment option for multiple food allergies
- Omalizumab is a monoclonal antibody directed against IgE which binds free IgE leading to down-regulation of IgE receptors and inhibition of IgE binding to mast cells and basophils
- Given as subcutaneous injections with the first few administered in office with eventual transition to home administration
High Risk Oral Food Challenges
- We offer and perform dose-eliciting OFCs to determine how much food someone needs to ingest before reacting to their food allergen which can allow families and clinicians to decide on potential food allergy treatment options and see how to treat a reaction in a controlled environment
- We offer support for providers in the Allergy/Immunology division to conduct higher-risk or urgent OFCs which can significantly impact patients and families with opportunities to determine tolerance or remove allergy labels if possible.
Emerging Treatments and Research
- There are also a number of exciting new potential treatments for food allergy currently being studied in research. These include epicutaneous immunotherapy (EPIT) or patch therapy, other biologic medicines, etc. Visit our Food Allergy Research page to learn more about current opportunities to participate in food allergy clinical research.
Compare Treatment Options
What is it?
A medicine for food allergies. It lowers the level of total IgE (immunoglobulin E – an allergy anbody) in your child’s body. This medicine is FDA-approved.
What does it do?
It lowers the risk of, and helps protect your child against, a bad reacon from any accidental exposures to the food they’re allergic to.
How is it given?
A shot (injection).
How often?
Every 2-4 weeks
Time commitment
For the first 3 doses, your child will come to the clinic so we can monitor them while they take this medicine. After they get the dose, they will stay at the clinic for 2 hours so we can monitor them for any allergic reactions. After 3 successful visits, they can get their shots at home.
How it works?
IgE is an allergy antibody. This is what causes an allergic reaction when it finds the thing you’re allergic to (allergen) in your system. This medicine decreases the IgE levels on your child’s allergy cells, which means their reactions are less severe.
Side effects
• The area where they get the shot may become sore, red, or swell
• Low fever
• Severe allergic reaction to the shot itself (rare, but serious)
Cost notes
This medicine can be very expensive. You will need prior authorization from your insurance (meaning they will need to work with your child’s provider to approve it before your child can take it).
Other Considerations
• This may not be the right choice if your child has a fear of needles or shots.
• This medicine may also help with other allergy conditions like chronic hives, asthma, etc.
• This is the only FDA-approved opon currently offered for multiple food allergies.
What is it?
Your child eats tiny amounts of the food they are allergic to and slowly eat more of it over time.
What does it do?
It lowers the risk of, and helps protect your child against, a bad reaction from any accidental exposures to the food they’re allergic to. OIT also allows your child to eat small amounts of the food they are allergic to.
How is it given?
Your child will eat small daily doses of their food allergen.
How often?
Every day
Time commitment
Your child will come to the clinic every 2 weeks for about 6 months. They will also keep taking their dose at home every day.
How it works?
Eating small amounts of the food allergen makes your child’s immune system learn to not trigger a reaction. We can then slowly increase how much of the food allergen your child eats. This is called “desensitization.”
Side effects
Common:
• Mouth itching
• Rash or hives
• Stomach pain
Your child could develop a taste aversion (or not liking the taste of the food). This is rare.
Rare but more serious side effects:
• Allergic reactions to the OIT doses (including anaphylaxis)
• Developing eosinophilic esophagitis (EoE).
Cost notes
• The cost depends on the food allergen product.
• A food allergen product that you buy at the grocery store are called “off-label” OIT.
• Your child will have many clinic visits and those have charges associated with them.
Other Considerations
• This likely helps your child get the most amount of desensitization and protection against food allergy reactions. But it does have higher rates of side effects.
• Your child will need to eat the food allergen itself.
What is it?
You put drops made with the food your child is allergic to under their tongue. Over time, the amount of food in the drops increases.
What does it do?
It lowers the risk of, and helps protect your child against, a bad reaction from any accidental exposures to the food they’re allergic to.
How is it given?
Daily doses of allergy drops under their tongue.
How often?
Every day
Time commitment
Your child will come to the clinic every 2 weeks for about 4 months. They will also keep taking their dose at home every day.
How it works?
Similar to OIT, we will desensize your child by giving them a small amount of the food allergen in liquid drops.
Side effects
• Mild mouth or throat itching
• Rare but more serious side effects:
• Allergic reactions to the SLIT doses (including anaphylaxis)
• Developing eosinophilic esophagitis (EoE).
Cost notes
SLIT may not be covered by your insurance. The cost varies, but your child will need some clinic visits which have charges associated with them.
Other Considerations
• Doing SLIT may not give your child as much protection from the allergen as Xolair® or OIT. This therapy does have a low rate of severe side effects.
• Currently there are no FDA-approved SLIT products.
• SLIT is a good opon for multi-food allergy therapy.
Meet the Team
Abigail T. Lang, MD, MSCI
Attending Physician, Allergy & Immunology
Nashmia Qamar, DO, MSCI
Attending Physician, Allergy & Immunology
Melanie M. Makhija, MD
Attending Physician, Allergy & Immunology
Madeline M. Schutt, MD
Attending Physician, Allergy & Immunology
Jennifer K. Bosworth, APRN, FNP-BC
Advanced Practice Provider, Allergy & Immunology
Julie I. Green, APRN-NP
Pediatric Nurse Practitioner, Allergy & Immunology
Make an Appointment
Our program requires a referral to begin treatment. Make an appointment with one the specialists from the Division of Allergy for an evaluation and referral to our program.
Our Locations
Ann & Robert H. Lurie Children's Hospital of Chicago
225 E. Chicago Ave.Chicago, Illinois 60611
312.227.4000
Lurie Children's Hospital Outpatient Center in New Lenox
1870 N. Silver Cross Blvd. (formerly Clinton Street)Suite 100
New Lenox, Illinois 60451
312.227.3620
Lurie Children’s Hospital Outpatient Center in Schaumburg
1895 Arbor Glen BoulevardSchaumburg, Illinois 60195
312.227.5800