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Concierge paediatric allergy · UK

Oral food challenge - the gold-standard answer when tests disagree.

For children whose allergy tests and history do not fully agree, and families who need certainty before nursery, school or nut-free travel. A resus-equipped clinic, a consultant paediatric allergist and adrenaline on the table.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why patients choose us

  • 01

    A consultant paediatric allergist, not a generalist

    Named consultants on the GMC specialist register with paediatric allergy fellowship training.

  • 02

    Skin prick, IgE and a written plan the same day

    A single visit that leaves you with a diagnosis and a plan the school nurse can act on.

  • 03

    Independent, and free

    We are paid by no hospital, so the recommendation - clinic, test, treatment - is impartial and costs you nothing.

Indicative pricing

What private oral food challenge costs in the UK.

In short

Oral food challenge in our network: £600–£1,200 per food, done in half a day.

ItemIndicative range
Pre-challenge consultation£250–£450
Single-food oral challenge£600–£1,200
Baked egg / baked milk challenge£600–£900
Peanut / tree nut challenge£800–£1,400
Two-food challenge (paired)£1,000–£1,800
Rescue treatment costs (included)Included
Post-challenge review + planIncluded

The problem

A resus-equipped clinic, a consultant on the floor, and adrenaline on the table.

  • The gold-standard test

    When history and IgE disagree, only a supervised food challenge gives a real answer.

  • Resus-equipped clinic, consultant on the floor

    Anaphylaxis pathway, adrenaline drawn up, paediatric-trained team throughout.

  • A plan for whatever the result is

    Passing, failing partway through, and inconclusive - each has a follow-up plan.

The journey

From enquiry to follow-up - what happens, in order.

  1. 01

    Before

    You tell us what is going on

    A short, confidential form. Age, symptoms, suspected triggers, previous reactions and medications.

  2. 02

    Before

    We come back with a recommendation

    Within one working day: the right paediatric allergist, indicative price, and whether testing or a challenge fits.

  3. 03

    Before

    Pre-clinic prep

    Non-sedating antihistamines stopped 3–5 days beforehand; asthma inhalers continued; eczema stabilised.

  4. 04

    On the day

    Consultation and history

    A detailed history from parent and child, then a targeted examination.

  5. 05

    On the day

    Testing on the same visit

    Skin prick, specific IgE blood draw or component testing - the right test for the story.

  6. 06

    On the day

    Written plan and rescue medication

    A BSACI-style management plan, prescriptions, EpiPen training if needed.

  7. 07

    After

    Follow-up and re-testing

    Review in weeks or months as appropriate; re-testing every 1–2 years for likely-to-resolve allergies.

When it helps

When oral food challenge is the right step.

  • IgE and history disagree

    A positive IgE without a clear reaction history - a challenge answers whether it is real.

  • Before a food ladder step-up

    Baked egg or baked milk before advancing home reintroduction.

  • Before nursery or school placement

    A definitive result changes the school plan and reduces anxiety.

  • Fading peanut or nut allergy

    When component testing suggests risk has dropped.

  • Suspected pollen-food syndrome

    To confirm the trigger and severity of oral symptoms.

  • Re-testing after a period on OIT

    To confirm and quantify tolerance developed.

  • Not for severe recent anaphylaxis

    A very recent reaction usually means waiting and re-testing later.

  • Red flag: airway swelling, breathlessness or collapse

    Adrenaline first, 999 second. Every family with a diagnosed allergy needs to be clear on this.

Options

Types of food challenge and when each is used.

  • Open oral food challenge

    The commonest - patient and clinician both know what is being given.

  • Single-blind challenge

    Patient blinded, useful when subjective symptoms cloud interpretation.

  • Double-blind placebo-controlled challenge

    The research gold standard - used clinically for complex cases.

  • Baked egg / baked milk challenge

    Muffin-based, standardised doses - the classic ladder decision point.

  • Peanut challenge

    Graded escalating doses over several hours.

  • Tree nut challenge

    One nut at a time, using culinary form.

  • Wheat challenge

    Sometimes exercise-augmented for WDEIA work-up.

  • Fresh fruit and vegetable prick-to-prick + challenge

    For pollen-food syndrome patterns.

Our vetted UK network

A small panel of specialists, we picked them.

A modern UK specialist clinic
  • Consultant paediatric allergists on the GMC specialist register
  • On-site skin prick testing with paediatric-trained nurses
  • Resus-equipped rooms for oral food challenges and immunotherapy
  • Direct access to paediatric dietetics and respiratory paediatrics

Safety and recovery

What to expect - honestly.

  • Small but real anaphylaxis risk

    Any positive challenge risks anaphylaxis - the reason every case is in a resus-equipped clinic.

  • Graded dosing minimises risk

    Doses escalate every 15–30 minutes with observation.

  • Observation after the top dose

    Usually 2 hours of observation after the final dose.

  • Asthma control is essential

    Uncontrolled asthma means postponing the challenge.

  • Recent infection or eczema flare

    Postpone if the child is unwell or badly flared.

  • Adrenaline may be given

    Every family is briefed on the possibility and the rescue plan.

  • Late reactions

    A small percentage of children react hours after leaving the clinic.

  • A negative challenge is not always the end

    Some children need home introduction to confirm long-term tolerance.

  • Red flag: airway swelling, breathlessness or collapse

    Adrenaline first, 999 second. Every family with a diagnosed allergy needs to be clear on this.

Your notes

Your report in four parts.

A UK consultant reviewing notes
  1. Header

    Food challenged and reason

    Which food was challenged and what question the challenge was answering.

  2. Technique

    Dose schedule and observation

    Escalating doses, timing and observation periods.

  3. Findings

    Reaction pattern and treatment

    Objective and subjective symptoms, and any rescue medication.

  4. Impression

    Diagnosis and plan

    Read this first: allergic or tolerant, dose limits and home introduction plan.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Paediatric allergy is available on the NHS but 6–18 months waits are typical for a first specialist appointment; it is usually covered by private insurers when medically indicated.

Frequently asked

Everything we get asked about oral food challenge.

  • When is an oral food challenge needed?

    When history and allergy testing do not agree, before advancing a food ladder (baked egg or milk), before nursery or school placement in a nut-allergic child, or after a period on oral immunotherapy to confirm tolerance.

  • What does the challenge involve?

    A pre-challenge check that the child is well and asthma is controlled, then escalating doses of the food every 15–30 minutes with careful observation. If a reaction happens the challenge is stopped and treated. If not, a full portion is given and the child is observed for another 2 hours before going home.

  • How much does an oral food challenge cost privately in the UK?

    Roughly £600–£1,200 for a single-food challenge, £800–£1,400 for peanut or tree nut and £1,000–£1,800 for a paired two-food day. The pre-challenge consultation is £250–£450.

  • Is oral food challenge available on the NHS?

    Yes, in paediatric allergy clinics, but waits can be many months and slot availability limits how many families can be booked.

  • How safe is it?

    Safe when done in a resus-equipped paediatric allergy clinic with a consultant on the floor. Anaphylaxis is possible in any positive challenge and the clinic is set up to treat it immediately.

  • Do we need to stop antihistamines first?

    Yes - non-sedating antihistamines are usually stopped 3–5 days before, and other medications may need pausing. The clinic will send a specific pre-challenge letter.

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