Skip to main content

Paediatric allergy · London

Multi-food oral immunotherapy programme - London.

A structured desensitisation for children aged 4 to 17 with peanut, tree nut, sesame, egg or milk allergy - built around a consultant paediatric allergist, an OIT-ready unit, and a family safety plan that includes school.

A stethoscope on a clinical desk

What families look for

  • 01

    A named paediatric allergist, in a specialist unit

    Not a general clinic list. A consultant paediatric allergist with a live OIT programme, in a centre set up for daily up-dosing visits and 2-hour observation.

  • 02

    The right protocol for your child

    Licensed Palforzia for peanut alone. Multi-food OIT for peanut plus tree nuts, sesame, egg or milk.

  • 03

    Independent information

    Pulse Atlas is an independent UK health information library and does not recommend or sell treatment at any clinic.

Indicative pricing

What a private OIT programme costs in London.

Indicative ranges across UK units.

In short

Palforzia peanut OIT in London: £14,000 to £22,000, all-inclusive for year 1.

Programme Indicative range
Initial paediatric allergy assessment and eligibility review £450 to £850
Oral food challenge (baseline, if required) £1,600 to £2,600
Palforzia peanut OIT (6-month up-dosing + year 1 maintenance) £14,000 to £22,000
Multi-food OIT (2 foods, 12 to 18 months) £22,000 to £32,000
Multi-food OIT (3 to 8 foods, 12 to 18 months) £32,000 to £45,000
Annual maintenance follow-up (year 2 onwards) £1,500 to £3,500

Prices vary by unit, by which allergist runs the programme, by whether Palforzia or a bespoke protein is used, and by how many foods are being treated.

The problem

The right allergist, the right protocol, the right unit.

A multi-food OIT programme run without daily discipline, a live asthma plan, and a specialist paediatric team is a plan to fail - or worse, to react.

  • What OIT actually is

    A daily controlled ingestion of gradually increasing doses of the allergen under supervision - the aim is desensitisation, not cure, so 300 mg or more of accidental exposure is tolerated.

  • Is Palforzia or multi-food right?

    Palforzia is licensed for peanut only. If your child has 2 to 8 coexisting food allergies, a bespoke multi-food OIT protocol is a different, longer conversation.

  • Want it done in a specialist unit?

    A named paediatric allergist, a unit with 2-hour observation and a paediatric anaphylaxis protocol, and a 24-hour phone line for the family.

Who it helps

Who benefits from OIT - and who should wait.

The children most often considered, plus the medical and lifestyle signals that mean OIT is deferred or a different pathway suits better.

  • Confirmed peanut allergy, age 4 to 17

    A clear IgE-mediated peanut allergy on history, specific IgE, skin prick, or a positive oral food challenge - the licensed Palforzia group.

  • Tree nut allergy (cashew, walnut, hazelnut)

    Single or multiple tree nut allergy in a child who wants to reduce the risk from accidental exposure at school, parties or restaurants.

  • Sesame allergy

    Sesame is a top-10 UK allergen with rising prevalence. Included in bespoke multi-food protocols alongside peanut and tree nuts.

  • Persistent egg or milk allergy

    Egg or milk allergy that has not resolved by age 4 to 5 and is not moving up the milk or egg ladder - a candidate for supervised OIT.

  • Multiple food allergies in one child

    Two to eight coexisting food allergies - multi-food OIT lets you desensitise several foods in one programme rather than sequentially over years.

  • Well-controlled asthma

    Asthma is not a bar to OIT, but it must be well controlled - a paediatric asthma review is part of the workup.

  • Committed family and daily routine

    Daily home dosing every single day, for years, plus clinic every 2 weeks for the up-dosing phase. Missed doses risk reactions on restart.

  • Not suitable: uncontrolled asthma or EoE

    Uncontrolled asthma, severe eosinophilic oesophagitis, systemic mastocytosis, or an inability to commit to daily dosing means OIT is deferred or declined.

Protocol options

OIT is a family of protocols - and SLIT and EPIT sit beside it.

What each option actually involves - and which fits which child. Outcomes: Palforzia peanut OIT desensitises 67% of children to 600 mg peanut protein after 12 months (versus 4% on placebo); multi-food protocols show similar efficacy per target food.

  • Palforzia peanut OIT (licensed)

    The only licensed peanut OIT product in the UK, NICE approved TA765 (October 2022) for age 4 to 17. Standardised 6-month up-dosing to a 300 mg peanut protein maintenance dose.

  • Bespoke single-food OIT

    A specialist-centre protocol using defatted nut flour or measured food doses for tree nuts, sesame, egg or milk where no licensed product exists. Same up-dose-and-observe principle as Palforzia.

  • Multi-food OIT (mixed protein)

    An Aimmune-model protocol mixing 2 to 8 allergenic proteins simultaneously in one dose, typically at specialist paediatric centres. Efficient for children with several coexisting allergies.

  • Sublingual immunotherapy (SLIT)

    Drops held under the tongue rather than swallowed. Lower efficacy than OIT but a lower rate of systemic reactions - occasionally used as a bridge or alternative.

  • Epicutaneous immunotherapy (EPIT)

    A peanut protein patch (Viaskin) worn on the skin. Investigational in the UK for children under 4 - your allergist will say whether a clinical trial spot is appropriate.

  • Milk and egg ladder reintroduction

    Structured graded reintroduction using baked then processed then raw milk or egg - a different pathway from OIT, often the right first step in early childhood.

  • Omalizumab-assisted OIT

    Omalizumab (anti-IgE) given for 8 to 16 weeks before and during up-dosing to reduce reaction rates - used in selected high-risk children in specialist centres.

  • Oral food challenge (baseline)

    A supervised in-clinic feeding of the allergen to confirm the diagnosis and threshold dose before any OIT programme starts.

Safety and daily life

What to expect on the programme - honestly.

OIT works but it is not a soft option. Side effects are common, adrenaline is sometimes needed, and the family carries the daily dose for years. Two in-date adrenaline auto-injectors and a MedicAlert bracelet stay in place throughout and after OIT.

  • Mouth and throat itch after every dose

    Mild oral itching or tingling for 30 to 60 minutes after each dose is common, especially early on. Usually settles without treatment or with an antihistamine.

  • Abdominal pain and vomiting

    Reported by 10 to 30% of children on OIT, usually mild and transient. Dose reduction or a temporary hold with a slower re-escalation may be needed.

  • Systemic reactions needing adrenaline

    Around 5 to 15% of children on OIT need adrenaline at some point during the programme. Two in-date adrenaline auto-injectors must be with your child at all times.

  • Eosinophilic oesophagitis (EoE)

    New-onset EoE occurs in around 5 to 10% of children on OIT - persistent reflux, food sticking, or vomiting warrants a gastroenterology referral and possible endoscopy.

  • Discontinuation is common

    Around 15 to 25% of families stop OIT because of side effects, reaction burden, or daily-dose fatigue. A frank discussion up front matters more than any protocol.

  • Daily dosing, without fail

    Missing doses for more than a few days risks a reaction on restart. Holidays, illness, and exam weeks all need a written plan and dose adjustments from the team.

  • Exercise and hot bath rule

    No vigorous exercise and no hot baths for 2 hours after every home dose - both raise absorption and reaction risk. Included in the family safety plan.

  • Adrenaline auto-injectors and MedicAlert

    Two in-date auto-injectors on the person at all times, annual family training, and a MedicAlert or equivalent bracelet stay in place throughout and after OIT.

  • When to call the team or 999

    Wheeze, throat tightness, difficulty breathing, faintness, or widespread hives after a dose - give adrenaline, call 999, then the OIT team.

Reading your OIT plan

Your OIT plan in four parts. Read the last one first.

Whichever protocol you are on, the written plan the allergist sends you keeps to the same shape.

A UK paediatric allergist reviewing an oral immunotherapy plan

A quiet reminder

Allergy language is precise and can read coldly - ask for anything unclear to be put in plain English.

If you would like the plan talked through before you start, just ask the allergy team.

  1. 01 Header

    Confirmed allergens and current threshold

    The foods being treated, current specific IgE and skin prick sizes, and the baseline threshold dose from history or oral food challenge.

  2. 02 Protocol

    Product, starting dose, target maintenance

    Palforzia or bespoke or multi-food, the starting dose in mg of protein, planned up-dose schedule, and the target daily maintenance dose.

  3. 03 Findings

    Reactions during up-dosing and dose changes

    A running log of any oral, gut, skin or systemic reactions, adrenaline use, and any dose reductions or holds during the programme.

  4. 04 Impression

    Maintenance plan, review and safety

    Read this first: the daily home dose, next clinic date, asthma review interval, and the family emergency plan.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover varies. Palforzia is NICE approved and NHS-available for eligible children, so insurers usually fund assessment and monitoring, not the drug. Bespoke multi-food OIT is usually self-funded.

Frequently asked

Everything patients commonly ask about multi-food OIT.

Quick answers on cure vs desensitisation, adrenaline, insurance, age, multiple foods, and discontinuation.

  • Is oral immunotherapy a cure for food allergy?

    No. OIT is a desensitisation, not a cure. It aims to raise the amount of allergen your child can tolerate before reacting - typically to protect against an accidental exposure of 300 mg or more of allergen protein per day. If daily dosing stops, the protection usually fades over weeks to months.

  • Does my child still need an adrenaline auto-injector?

    Yes. Every child on OIT continues to carry two in-date adrenaline auto-injectors, wears a MedicAlert bracelet, and has an annual family training refresher. Reactions can still occur during and after OIT, and the safety plan does not change.

  • Will private health insurance cover OIT?

    Cover varies. Palforzia is NICE approved (TA765) and available on the NHS in England for eligible children, so private insurers may cover assessment and monitoring but not the drug itself. Bespoke multi-food OIT is usually self-funded.

  • What age range is oral immunotherapy for?

    Palforzia is licensed for children aged 4 to 17. Bespoke and multi-food OIT protocols run in a similar age range in UK specialist centres. Earlier introduction of allergenic foods (LEAP-style) is a different, prevention-focused pathway for infants.

  • Can more than one food allergy be treated at once?

    Yes - multi-food OIT protocols use a mixed-protein dose that treats 2 to 8 foods simultaneously. Efficacy per food is broadly similar to single-food OIT. Not every child is a candidate, and the programme is longer and more intensive than Palforzia.

  • How often do families discontinue OIT?

    Around 15 to 25% of families stop OIT before reaching maintenance, usually because of side effects, reaction burden, eosinophilic oesophagitis, or the load of daily dosing. A frank conversation about time, cost and family commitment happens before any programme starts.

Related tests and treatments

Looking for something else?