What is Oral Immunotherapy?

Oral Immunotherapy (OIT) is an innovative treatment that works by gradually exposing your child’s immune system to small amounts of the allergenic food, helping their body become less sensitive over time. The goal is to reduce the severity of allergic reactions or eliminate them entirely, providing your child with greater freedom and peace of mind.

For children with food allergies, OIT is an effective and supervised method that involves ingesting the allergenic food under controlled medical conditions. It’s an approach that has shown great promise, particularly for allergies to foods like peanuts, milk, and eggs, while also being useful for some environmental allergens.

Though OIT is highly effective, it requires a long-term commitment and a gradual approach, often taking months to a year to show significant improvements. But the results can be life-changing, offering your child a safer, more enjoyable life with fewer restrictions.

How Does Oral Immunotherapy Work?

Oral Immunotherapy (OIT) is a step-by-step process that helps desensitize your child’s immune system to food allergens. The treatment is carried out under the supervision of a trained allergist to ensure safety and effectiveness.

1. Initial Consultation and Testing:
   • Your child will undergo allergy testing, including skin prick tests, blood tests, and possibly oral food challenges to identify the specific foods to which they are allergic. This helps the allergist determine if OIT is the right treatment and tailor it to your child's unique needs.
2. Starting the Treatment:
   • OIT begins with small, controlled doses of the allergenic food, usually in the form of a powder or liquid. This is administered in a clinic setting under medical supervision to monitor your child’s reaction.
3. Home Dosing:
   • Once a dose is tolerated under medical supervision, you will give your child that same dose daily at home. The dose is mixed with a semi-solid food such as yogurt, a smoothie, or applesauce and consumed at approximately the same time each day. You will receive instructions on how to reduce the risk of reactions to the daily dose and treat any symptoms that may occur.
4. Building Tolerance:
   • As the treatment progresses, the dose of the allergenic food is gradually increased. This process, known as desensitization, helps reduce the severity of allergic reactions over time, allowing your child’s immune system to better tolerate the food.
5. Maintenance Phase:
   • Once your child reaches the optimal dose, they enter the maintenance phase, where they will take a prescribed daily dose of the allergenic food at home. Regular follow-up appointments ensure the treatment is working effectively.
6. Long-Term Benefits:
   • Over time, your child may experience a significant reduction in allergic reactions, including a decrease in the severity of symptoms. You will no longer have to worry about reactions to trace amounts of foods and will be able to eat at restaurants without fear. In some cases, children can consume the allergenic food safely without experiencing a reaction.

The Benefits of Oral Immunotherapy for Children

Oral Immunotherapy offers several benefits that can significantly improve your child’s quality of life:

• Increased Safety: By gradually desensitizing your child’s immune system, OIT can reduce the risk of life-threatening reactions, such as anaphylaxis.
• Improved Quality of Life: With reduced sensitivity to allergens, your child may be able to enjoy foods and activities that were previously off-limits, enhancing their social life and overall well-being.
• Reduced Dependency on Medications: As your child’s immune system becomes less reactive, they may need fewer medications, such as antihistamines or epinephrine, to control their symptoms.
• Personalized Treatment: OIT is tailored to your child’s specific allergens and previous reaction severity, ensuring that the treatment is as effective and safe as possible.
• Remission: the earlier OIT is started, the better the chance it may induce remission of your child’s food allergy. Remission occurs when a child can consume a full serving of the food without symptoms. 

The OIT Treatment Process: What to Expect

Here’s what you can expect during the Oral Immunotherapy treatment process:

1. Initial Consultation and Allergy Testing:
   We begin with a comprehensive consultation where we assess your child’s medical history and symptoms. Our allergists will also perform necessary allergy testing to confirm which food allergens need to be treated.
2. Starting the Treatment (Build-Up Phase):
   The treatment begins with very small doses of the allergen, which are gradually increased over time. The build-up phase generally takes 6-12 months, depending on your child’s specific needs and the severity of the allergy. During this phase, you will come into the clinic every 2-4 weeks to increase the dose. Visits typically last 1-3 hours. Between visits, your child will consume their dose daily at home.
3. Maintenance Phase:
   Once your child reaches the optimal dose, they enter the maintenance phase, where they will continue to take a prescribed dose of the allergenic food daily at home. This dose ranges from 1-4 nuts, 2-4 tsp milk, or a portion of a scrambled egg. This phase typically lasts 2-4 years, with regular follow-up visits to monitor progress.
4. Follow-Up and Monitoring:
   The goal of OIT is to integrate foods into the diet, at whatever dose your child tolerates. Follow-up visits are essential to ensure the treatment is working and to make any necessary adjustments. Your allergist will continue to monitor your child’s progress, assess any potential side effects, and ensure they remain desensitized to the allergen.

Is Oral Immunotherapy Right for Your Child?

Oral Immunotherapy is a great option for many children with food allergies, but it’s not the right fit for every case. OIT is most commonly used for food allergies such as peanut, tree nuts, egg, milk, sesame, wheat, soy, fish, and shellfish.

However, not all allergies respond to OIT, and a thorough evaluation is needed to determine if it’s suitable for your child. This treatment is particularly beneficial for children with severe allergies who may be looking for a long-term solution. If you’re interested in learning more about whether OIT is the right treatment for your child, contact our office to schedule a consultation.

Potential Risks and Side Effects of OIT

While Oral Immunotherapy is generally safe when conducted under the supervision of a trained allergist, there are potential risks and side effects to consider:

1. Mild Symptoms:
   Most children experience mild side effects, such as itchy mouth, stomach discomfort, or hives in the early stages of treatment.
2. Moderate Reactions:
   Occasionally, symptoms like vomiting, coughing, or swelling may occur. To keep your child safe, you’ll have a written Allergy & Anaphylaxis Emergency Plan and access to an allergist by phone or text for guidance and support..
3. Severe Allergic Reactions:
   Although rare, some children may experience anaphylaxis or other severe reactions. Thankfully, 98% of allergic reactions resolve with 1 or 2 doses of epinephrine, so you should always have your child’s epinephrine auto-injectors available during home dosing. 

Conclusion

Oral Immunotherapy is a groundbreaking treatment that reduces the risk and severity of reactions to accidental ingestions of food allergens. By gradually desensitizing the immune system to allergens, OIT provides a safer, more flexible lifestyle for your child, free from the constant worry of allergic reactions.

If you’re interested in learning more about Oral Immunotherapy and how it can help your child, Empower Allergy Treatment is here to help. Contact us today to schedule a consultation and begin your child’s path to food allergy relief.