What to think about oral immunotherapy? A mother testifies.

For decades, avoiding the food responsible for food allergies was the only solution available. For several years, a new approach to care has emerged. This is oral immunotherapy (OIT). We will follow the journey of an 11-year-old child with multiple food allergies from the initial provocation test to the implementation of the ITO. Her mother Chloé tells us.

The initial stage: the TPO

My 11 year old son has been multi-allergic since the age of 1 with the discovery of an egg allergy. Then everything came together with allergies to cats, dogs and nuts. His first anaphylactic reaction at 3 1/2 years old was with peas. Then he reacted to the horse with a major reaction by eating trout around the age of 4. In the same year there was an increase in moderate reactions with sheep’s milk, goat’s milk, melon and lentils. On the advice of the allergist and after assessment, we removed fish, nuts and legumes from his diet. In case of contact with these foods, he could present symptoms such as edema of the larynx (his voice changed) and mouth, difficulty breathing and hives. During 2023, our allergist suggests that we send him, as part of his assessment, an oral provocation test (OPT) carried out at the hospital, for fish and another for peanut in March 2024. They went well, without stress.

My son loved fish before the allergy so he was very motivated. For peanuts, it was much less so! But the puffed peanut biscuits given during the TPO convinced him. The hardest part, according to him, is the catheter during hospital days. Good news, he can eat certain fish again but cooked! No question of Sushi!

I am convinced that by supporting our children in these steps we can really improve their quality of life. Each time I am amazed by the support provided by the medical teams. They are really fantastic at helping children. I still emphasize the importance of really being as calm as possible to help your child.

A severe reaction to hazelnut;

In June 2024, he suffered anaphylaxis after accidental contact with hazelnuts. We were scared!

The beginning of ITO with hazelnut

A few months later on November 12, 2024, hazelnut immunotherapy began. You must initially go through the TPO box to know the dose that will need to be taken at home. I won’t hide from you that with the anaphylactic shock previously, this time it was a lot of stress for my son. He was able to explain his fears when he arrived in the morning, he was listened to and a nurse offered him hypnosis to relax and the mask with laughing gas for catheter installation. It went very well. Minimal symptoms occurred with the 1/12 quantity of hazelnut wafer. So the medical team did not increase the doses. My son has to take this small amount every day.

It was clearly explained to me that my child should not play sports or get angry within 2 hours of taking the small piece of wafer.

I say it again, you have to be as calm as possible to help your child. And then children’s hospitals are also places that try to be nice and welcoming: my son plays table football with another patient, they laugh… it’s nice. There are games. We ask them what they prefer to eat… well, I’m really amazed by their kindness.

ITO: the child’s feelings.

Stressed as I told you but he tells me he felt confident and well cared for when we proposed methods to reduce stress. Happy afterwards because he liked the taste of the cookie!

And the same goes for when he started to feel the first reactions to the third dose: the nurses and the doctor explained that it was normal and logical… he was reassured and motivated to continue, especially, he says, that we announced that in a while, if it works, there will be chocolate candies and a famous chocolate bar as part of the protocol!

And what’s next?

We have to return to the department in December to see where things are going with the hazelnut and adapt the protocol.

6 TPOs planned for early 2025: almonds, cashews, pistachios, peas, lentils and chickpeas

At the same time, he starts eating eggs again in small quantities in industrial cakes

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