Food challenge coming up... can anyone help?

[QCmama]

Hello everyone,
I'm new here! I have been reading through some of your threads, which are all so helpful...thank you!

My daughter is preparing for a food challenge to hazelnut. She doesn't know about this yet, but we are pretty nervous (ok, excited, too, but nervous). I asked this question of the allergist and a nurse, but not sure what to do. If any of you have been through this or could tell me what you WOULD do, I'd appreciate it... would you bring in Nutella for the oral challenge or the actual raw hazelnut? I assume they're slightly different but that the raw hazelnut would be more accurate (?). As far as I know, she's never eaten anything with raw hazelnut before.

What do you all think?

Thanks in advance for your help!

[rebekahc]

Hello and welcome!  How exciting (and scary) that your DD is doing a food challenge!

We have never done a hazelnut challenge, but I think I remember reading here that one doctor would not allow Nutella for challenges because it doesn't contain enough hazelnut to be accurate.  However, just raw hazelnut sounds pretty blech to me.  Hopefully those who've done hazelnut challenges will have some ideas.

[QCmama]

Thank you for the welcome and for your reply! I wonder why the doctor is ok with Nutella. Doesn't seem logical to me. Ugh, another thing to worry about.....

I also just asked for a copy of her blood RAST test results. When they told me they were all negative, I think I was just too shocked to even ask for a copy, so I don't know the levels.

Does anyone here have any recommendations for what the range should ideally be to warrant a food challenge?

Thank you all!

[CMdeux]

Well, if they are negative, then in the absence of pretty suggestive history (that is RECENT) then that would indicate a pretty good chance of success.

We've done a hazelnut challenge.

I'd ask your doc if s/he is okay with nutella for the challenge.  Honestly, the convenience factor and the texture would seal the deal for me there if I had it to do over again.

Here's what we ACTUALLY did for my DD's hazelnut challenge, knowing that she is very definitely anaphylactic to other nuts:

1.  bought in-shell hazelnuts from a local grower (not an option for many people-- you'll have to get them from a local store)

2.  Because said grower also handles almonds in-shell and occasionally walnuts, we WASHED THE HAZELNUTS WHILE STILL IN THE SHELLS.

3.  I dried them out in a low temp oven on cookie sheets on foil-- about 250F for an hour or so

4.  Then I cracked them open and extracted the nut-meats, and ground them using a new, never been used coffee grinder.


Honestly, you can see where the Nutella would be WAY easier than this.  WAY.  I'm not 100% sure that I would have trusted my procedure with grocery-store filberts/hazelnuts due to contamination.

[ajasfolks2]

We have 1 child who may be allowed to challenge hazelnut this coming year.

We're planning to do what CM suggested above -- hazelnuts in shell (will likely order online or get friend to ship to us from trusted supplier such as what CM uses above), WASHED & dried, and cracked with new nutcracker so little risk of X-contamination.

If we get some latitude, we want to schedule this child's challenge in the middle of winter when other environmental and seasonal allergies are not flaring.  We hope this will give us best chance at true read on hazelnut.


Welcome to our boards! 

[QCmama]

Thank you all!

This food challenge is next week, hoping her cold is gone by then. Would you think nutella would be ok or not precise enough? The dr says he uses nutella for the hazelnut challenges, but this makes me nervous in terms of accuracy.

Thanks again!

[PurpleCat]

I don't have a hazelnut suggestion but having gone through a few food challenges I do have these suggestions (I don't know how old your kiddo is)

Bring board games (that don't need a lot of space), cards or other similar busy distractions for during the challenge.  Or you will find yourself staring at your kiddo, scrutinizing her while waiting for each nurse check and next dose.  I found talking to DD as we played a game allowed me to watch her and notice if there were changes such as coughing, tone of voice, etc... without watching her directly.  And it helps pass the time.  Her challenges were about 4 - 5 hours long.  I even taught her how to finger knit during one of them.

Good luck!

[CMdeux]

Please note that most domestic hazelnut growers are now NOT shipping directly to consumers-- but only to wholesaler/cooperatives.

I live in a hazelnut growing area, and I have some back-stock (which is-- I think-- what Ajas is thinking since she and I are friends)-- but our former source is no longer viable.

http://stores.hazelnuthill.com/blog/anticipated-closure-september-15-2014/

[Macabre]

Take a change of clothes. At least in the car--in case. Your kiddo doesn't even have to know you've brought them.

[QCmama]

These are all great tips that I haven't even thought about... thank you!

I'm going to stop by Whole Foods on my way home from work on the off chance they have package hazelnuts that haven't come into potential contact with anything else. Hmm. Should be interesting.

Curious as to why the doctor didn't balk at the idea of Nutella. Not sure if this should concern me and if I should call someone else.

[Macabre]

Do you also deal with peanut allergy?  Nutella is peanut free.

It would be difficult to tell on the packaging of the hazelnuts have come into contact with other treenuts or peanuts.

[Macabre]

I meant to add--we did not have an IOFC. DS was negative and his (FA guru) allergist said to try Nutella and we did and it was fine.


If I had to do an IOFC and my allergist didn't balk at the Nutella, I wouldn't worry about it frankly. I'm sure the concentration is adequate. Now knowing the exact amount is obviously a problem of course.

[CMdeux]

I agree-- honestly, if the doc is okay with nutella, I'd just use it-- it's the most likely dietary source, ultimately, because of the convenience.

Things that I routinely take to a food challenge:

a) an overnight bag for me-- change of undies, comfy stretch pants, slipper socks, and toothbrush/deodorant, etc.

b) a change of clothes for both me and my DD, and an extra trash bag along with some clorox wipes

c) a couple of cans of ginger ale, or bottled water

d) portable gaming/video system

e) reading material

I tend to leave A and B in the car.  The rest comes in with us in a tote bag. 

[QCmama]

Thank you again! Yes, Nutella is most likely source here, but if we were to travel, say, to Europe one day (who knows when!) I think we'd find more with actual hazelnuts. It may be sufficient, though. I'll investigate between now and next week.

Thank you!

[CMdeux]

Nutella is very common in Europe.  I was so, so glad that we had this in our back pocket when we were in Europe.  It was really a relief not to fear all of the little crepe stands in Paris, for example, and the tiny neighborhood shop in Dublin had little jars of the stuff, even, which delighted my DD no end.