FOOD ALLERGY OIT DOSE TIPS AND TRICKS
If you’re feeling frustrated and looking for food allergy OIT tips and tricks to get your toddler or older child to eat their food allergy OIT dose, you’re in the right place.
How do you get kids to eat a food they’ve been taught all their life to avoid? The mere thought of ingesting your allergen in an OIT dose can cause fear and anxiety, not to mention a serious gag reflex. As a result, parents need to be clever and creative and maybe a little sneaky in their delivery method when administering their food allergy OIT dose.
First, let’s define OIT so we’re all on the same page.
WHAT IS OIT?
Oral immunotherapy (OIT) refers to the medically supervised therapy of feeding an allergic individual an increasing amount of an allergen with the goal of increasing the threshold that triggers a reaction.
The goal of therapy is to raise the threshold that may trigger a reaction and provide the allergic individual protection against accidental ingestion of the allergen. OIT is not a curative therapy and involves a long-term commitment over several months to years and possibly indefinitely. Individuals who receive OIT will continue to carry epinephrine, read labels closely, etc., and it is not expected that OIT will lead to ingestion of the allergen without limitation. (Definition from AAAAI.)Remember, OIT treatment should only be performed under the supervision of a board-certified allergist.
For more detailed information about the Current State of Oral Immunotherapy (OIT) for the Treatment of Food Allergy, go to the American Academy of Allergy Asthma and Immunology.
FOOD ALLERGY OIT
Depending on whether the dose food is whole, crushed, powder, or liquid, different methods may make eating the dose more palatable.
Some kids prefer savory while some prefer sweet.
In general, chocolate enhances the nut flavor, while mint and citrus mask the flavor better.
Cinnamon and Peppermint extract add spiciness that may help to cover up a nut flavor.
Coffee can cover up a nut flavor.
Choose foods with strong flavors to hide or mix the dose in. For example, tomato sauce and cheese.
The amount of dose may also influence your delivery method. For example, it may be easier to eat whole nuts instead of its equivalent in nut flour.
CREATIVE OIT DOSING IDEAS
Daily dosing can be stressful and a real struggle. Even when you find just the right way to mix up the dose, your OIT child may decide it’s unacceptable after a period of time and you’ll need some new ideas and some tricks up your sleeve. This rings true even a few years into maintenance. So definitely try a variety and see what works.
If you’re able to, dose with your child so he/she doesn’t feel like they have to eat their allergens alone.
CAUTION: Only add the dose to foods that you know your child is not allergic to and has safely consumed previously.
Remember that the most important goal is to get the child to eat their entire dose as easily as possible. Try to minimize the amount of food+dose, so that they can be done quicker. Also, some of the creative OIT dosing ideas below may not be the healthiest choice, but they get the job done. So let’s get on with some food allergy OIT tips and tricks!
Be sure to check with your allergist to confirm the dosing delivery method is appropriate for your treatment. For instance, sometimes heating or cooking is allowed, sometimes not. Likewise, certain allergens may be purchased raw, roasted, pan cooked, or steamed. Everyone’s food allergy treatment is individual and different. Always ask your allergist to get approval before trying a new dose form, especially during the buildup phase.
Also, take extra precaution if you intend on making a cooked dose. Check with your allergist before cooking or baking egg flour, milk flour, or any flours.
OIT DOSE LOG
Download a Monthly OIT Dose Log to keep track of your daily dosing. This sheet has enough space for 4 allergens.
Or stay extra organized with this Food Allergy Immunotherapy Daily Dose Log Book – 12 months, undated. Track OIT progress and treatment details. Record time and/or amount taken for each dose. Space for reaction and detailed notes. Keep track of dose escalations and reactions.
OIT Support Group on Facebook – Join discussions with others going through oral immunotherapy. You’ll find a supportive community of prospective patients, current patients, and graduates.
Oral Immunotherapy (OIT) Graduates Support Network on Facebook – For parents and patients who have graduated from any Oral Immunotherapy Food Allergy Treatment Program and are navigating maintenance dosing during the years following graduation.
OIT DOSE IDEAS FOR ALLERGEN FLOURSCheck with your allergist before cooking or baking egg flour, milk flour, or any flours.
- Stir the dose into applesauce. Try cinnamon flavor for extra masking effect.
- Stir the dose into Snack Pack chocolate pudding.
- Stir the dose into dairy-free pudding. Snack Pack Lemon Pudding, Mango Pudding, and Dragon Treasure Pudding flavors are milk-free.
- Stir into oatmeal.
- Mix dose into a milkshake.
- Mix dose into orange juice or mango nectar. Thick juices will hold the flours better.
- Mix dose into a fruit smoothie.
- Mix dose into a banana Oreo smoothie.
- Mix dose into a Kool-Aid drink, a flavored drink mix powder. Optionally dispense with a syringe.
- Mix dose into chocolate milk. Add cinnamon or peppermint extract for extra masking effect.
- Mix dose into a hot chocolate with peppermint extract for extra masking effect.
- Mix dose into yogurt.
- Mix dose into drinkable yogurt or kefir.
- Mix dose into the filling of a Double Stuf Oreo. Remove filling, mix dose into filling, rebuild Oreo.
- Mix dose into chocolate frosting. Pillsbury frosting is free of nuts, dairy, and eggs.
- Mix dose with fruits that have seeds. Strawberry and raspberry seeds will help to mask the texture.
- Mix dose into whipped cream.
- Mix dose into chocolate syrup.
- Mix dose with ice cream. Try mint chocolate chip or coffee flavors for extra masking effect.
- Muffin or cupcake. Portion out batter for each muffin, then stir in 1 dose per muffin before baking. Betty Crocker muffin mix or try out these Green spinach banana muffins recipe.
- Cookie. Portion out dough for each cookie, then mix in 1 dose per cookie before baking. Betty Crocker cookie mix or try this Dairy free sugar cookie recipe.
- Brownies. Portion out batter for each brownie, then mix in 1 dose per brownie before baking. Cherrybrook Kitchen brownies.
- Cook dose into pancakes. Mix dose into individual portions of pancake mix, cook.
- Cook dose into waffles. Mix dose into batter for 1 waffle.
- Mix dose into maple syrup to top pancakes or waffles.
- Cook dose into crepes.
- Cook dose into omelets.
- Incorporate into chocolate. Melt chocolate, add dose, let harden in fridge.
- Mix dose into fudge.
- Add the dose flour under the cheese of a cooked pizza. Just peel up the cheese and sprinkle inside.
- Mix dose with refried beans and serve as a dip or spread on a tortilla.
- Add dose into a cheese quesadilla.
- Add dose into a cheeseburger.
- Add dose into a burrito.
- Add dose into spaghetti sauce.
- Add dose into the middle of a sandwich.
- Chips and dip. Mix the dose into to the dip (salsa, hummus, guacamole, etc.).
- Mix the dose into salad dressing. Eat with chips or veggie sticks.
- Mix dose into ketchup or BBQ sauce. Eat with tater tots or French fries.
- Mix dose into sunflower seed butter (if not allergic to sunflower seeds).
- Mix dose into mashed potatoes.
- Add dose to Oatmeal Date Balls. In a food processor, blend 6 pitted medjool dates and 1/3 cup old fashioned oats into a thick batter. Roll batter into balls while mixing in 1 dose per ball. Refrigerate.
IN A RUSH? WANT DOSE IDEAS FOR ALLERGEN FLOURS SENT TO YOUR INBOX?
If you’re measuring out your food allergen doses, here are 2 great scales that can weigh out small amounts of food. You’ll also need a lightweight container to hold the food, be it nuts, flours, etc. Just place your container on the scale. Press the TARE button to reset the weight back to zero, then add your dose.
WHOLE NUTS vs. NUT FLOURS
As you get closer to a larger maintenance dose, it may make sense to switch to whole nuts vs. nut flours. Each allergist will have their own protocols.
If your child willingly eats a dose of whole nuts, you have it easy! No need to jump through any hoops. If not, check out the food allergy OIT tips and tricks below for whole nuts.Check with your allergist for protein equivalency as brands differ in protein contents.
SIMPLE OIT DOSE TIPS FOR PEANUTS AND WHOLE NUTS
- Peanut M&M’s Be aware whether you’re using Regular or Mega size.
- Snickers bar
- Nutter Butter Peanut Butter Cookie
- Chocolate covered cashews.
- Candied cashews.
- Coconut covered cashews.
- Candied walnuts.
- Candied pecans.
- Sliced almonds.
- Incorporate into chocolate. Melt chocolate, add dose, let harden in fridge.
- Eat nuts together (same mouthful) with Andes Mints chocolate or Enjoy Life chocolate chips.
- Make a fruit smoothie. Soak the nuts in water to soften, strain and discard the water, then add fruits and liquid, blend. Aim to make the smoothie as small as possible so that your child won’t have to drink a huge amount to get the full dose. Start with 2″ of frozen banana, 2 strawberries, and any liquid. When done, swirl some juice around to get any remaining dose smoothie and drink that too. You could use any types of berries such as strawberries, blueberries, raspberries, blackberries, etc.
- Add crushed nuts to a taco.
- Add crushed nuts to ice cream.
- Eat together with corn chips to mask the crunch of the nuts.
- Add crushed nuts to Oatmeal Date Balls. In a food processor, blend 6 pitted medjool dates and 1/3 cup old fashioned oats into a thick batter. Roll batter into balls while mixing in 1 dose of nuts per ball. Refrigerate.
MORE CREATIVE NUT OIT DOSE IDEAS
Nut butters below can be spread on celery, apples, crackers, toast, etc.
- Peanut butter M&M’s.
- Reese’s peanut butter cups.
- Reese’s Pieces
- Hazelnut Nutella
- Cashew butter
- Peanut butter
- Barney Almond Butter
- Use original Bamba or Trader Joe’s Bamba peanut snack.
EASY MILK OIT DOSE IDEAS
- Ice cream
- Frozen yogurt
- Mix milk with chocolate syrup. To make a larger quantity to drink, add rice milk.
- Mix milk with Nesquik chocolate powder or Nesquik strawberry powder
- Drink milk with Milk Magic flavored straws (cookies and cream, chocolate, strawberry, cotton candy).
- Cheese toast
- Milk chocolate
- Snack Pack chocolate pudding
EGG OIT DOSE TIPS
- Mix Augason Farms egg powder into applesauce, fruit/veggie sauce pouches, baby food, yogurt, flavored soy milk
- Flavored MuscleEgg shake. Blend with banana and other fruit
- Mix egg powder into chocolate pudding
- Mix into a drink, such as milk shake, fruit smoothie, chocolate milk, fruit juice, lemonade
- Mix egg powder into BBQ sauce, pasta sauce, gravy
- Hard-boiled egg
- Scrambled egg
- Crème caramel, flan
- Egg frittata
- Breakfast sandwich with egg, cheese, ham, bacon on English muffin or croissant
SESAME SEED DOSE TIPS & TRICKS
Regular sesame seeds are typically eaten savory or sweet. Black sesame is often used for sweet desserts.
- Sprinkle sesame seeds onto rice.
- Sprinkle sesame seeds onto sushi.
- Stir sesame seeds into oatmeal.
- Stir sesame seeds into rice porridge.
- Add sesame seeds into thick soups like lentil soup or split pea soup.
- Sesame candy.
- Sesame crackers.
- Sesame covered bread sticks.
- Spread sesame tahini on toast.
- Dip crackers into sesame tahini.
- Mix sesame tahini with pasta.
- Mix tahini into chocolate pudding.
- Mix tahini into applesauce.
- Mix tahini into yogurt.
- Spread chocolate tahini on crackers.
- Dip marshmallow into chocolate tahini.
- Store bought hummus contains sesame tahini.
- Add sesame tahini to home-made hummus.
- Mix black sesame tahini into vanilla ice cream.
- Blend black sesame tahini into fruit smoothie.
- Dip marshmallow into black sesame tahini.
Kevala brand is made in a Peanut free facility.
Check with your allergist for protein equivalency as brands differ in protein contents.
SIMPLE FLAX SEED (LINSEED) OIT DOSE TIPS
- Sprinkle flax seeds onto rice.
- Stir flax seeds into rice porridge.
- Add flax seeds into thick soups like lentil soup or split pea soup.
- Stir flaxseed meal into oatmeal.
- Mix flaxseed meal into a fruit smoothie.
- Add flaxseed meal to muffin or cupcake. Portion out batter for each muffin, then stir in 1 dose per muffin before baking. Betty Crocker muffin mix or try out these Green spinach banana muffins recipe.
- Add flaxseed meal to brownies. Portion out batter for each brownie, then mix in 1 dose per brownie before baking. Cherrybrook Kitchen brownies.
- Add flaxseed meal or seeds to cookie dough and bake.
- Cook flaxseed meal dose into pancakes. Mix dose into individual portions of pancake mix, cook.
- Mix flaxseed meal with water and honey to make an Ethiopian drink called Telba. Just stir together and let sit for a few minutes as the flaxseed meal absorbs the water and thickens slightly.
PRE-GROUND NUTS or NUT FLOURS
You can order ground nuts from nuts.com. Be aware of whether you require a facility that processes only your specific nut or if a shared facility is acceptable. Storing them in the freezer prolongs the life of the ground nuts.
OIT CONVENIENCE IDEAS
Use a weekly pill organizer box and fill with 1 week worth of doses.
MORE ESSENTIAL OIT DOSING TIPS & TRICKS
- Make sure the stomach is not empty when dosing! Eat some carbs.
- Whatever you mix your OIT dose into, make sure that the entire mixture is consumed so that you get the full dose. So try to make smaller dose mixtures.
- When combining flours with applesauce, mix dose in and let it sit for a few minutes so the flours absorb the moisture. The mixture will be smoother.
- Eat some crackers before the dose, so your molar grooves fill with crackers instead of nuts.
- To help alleviate the start of an itchy mouth, eat something cold, like ice cream.
- Use a delicious chaser (like a safe candy/cookie) after your dose to “chase” and get rid of the dose taste.
- Eat a Tic Tac mint after dosing to get rid of the dose taste.
- If your child has braces, he may not be able to chew whole nuts and you may need an alternative.
- Some allergists ask you to dose by whole nuts.
- Some allergists ask you to measure out the food by weight.
- FYI: Original and Double Stuf varieties of Oreos are made on peanut and tree-nut free lines.
Most allergists recommend a REST PERIOD of 1 hour before and 2 hours after dosing. To minimize an allergic reaction, they recommend no exercise for 2 hours after dosing. Check with your allergist to see what their rest period protocol is, if any.
Just to be clear — Be sure to check with your allergist to make sure the dosing delivery method is appropriate for your treatment. For instance, sometimes heating or cooking is allowed, sometimes not. Likewise, certain allergens may be purchased raw, roasted, pan cooked, or steamed. Everyone’s food allergy treatment is individual and different. Always ask your allergist to get approval before trying something new.
Do you have a way of dosing that works for you? Please share in the comments below!
Interested in reading some OIT journeys in detail? Here’s 3.
- Neil – egg and tree nuts
- Connor – peanut and tree nuts
- Keira – dairy, peanut, tree nuts, seeds, seafood with Xolair
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