Below - Links to each of separate Oral Immunotherapy FAQ pages for Peanut, Wheat, Milk and Egg published on the website of Dallas Allergy Immunology.
Following the links below I have copied a few of the 27 Frequently Asked Questions about Oral Immunotherapy for Peanuts as published on the website of Dallas Allergy Immunology www.dallasallergy.net (which is Dr. Wasserman's website).
Links to the pages for the Oral Immunotherapy FAQ's. Each allergen has it's own page dedicated to questions for that particular food and its respective oral immunotherapy program.
Below are a few of the PEANUT FAQ's I found most helpful. On the Dallas Allergy website there are 27 frequently asked questions and the relevant answers to each.
Question 1:How long will the entire process take?
A. The first day procedure will take about 7-8 hours. If there are no reactions during the oral immunotherapy, you child will be eating a full serving of peanuts in about three months.
What is the timeline for the months after the first day?
A. Exactly how it will go depends on each individual child. If everything goes well, some amount of the whole food will be eaten during the second month and a whole serving of peanuts may be eaten by the fourth month. By four months, if there are no reactions, two doses per day will be required to maintain desensitization. After one year the dosing frequency will be reduced to once a day.
How often can the dose be increased?
A. The interval between dose increases is a minimum of seven days.
What time of day should home doses be given?
A. For twice a day peanut dosing, try to make the interval between peanut doses no less than 9 hours and no more than 15 hours.
Question 8: How long should my child stay awake after the evening dose?
A. Children should be observed for at least one hour after the dose is given. They should not be allowed to sleep during this time.
Question 10: If there is a reaction at home, what should I do?
A. Treat the reaction the same way you would any food reaction; antihistamine if there is just rash, Epi-pen if there are other symptoms of anaphylaxis. If there is just one or a few hives, DO NOT give antihistamine for the first hour so we can see if the reaction progresses. If the hives are increasing, give antihistamine. Call us after the appropriate immediate intervention. We will give instructions on future dosing.
Question 21: Does my child need to avoid exercise during the oral immunotherapy process?
A. Exercise should be avoided for at least two hours after peanut dosing, but it is ideal to avoid exercise for four hours after dosing. Exercise following peanut dosing increases the chance of a reaction.
Question23: How much peanut can/must my child eat following completion of the oral immunotherapy process?
A.Your child must ingest 8 peanuts twice daily as a maintenance dose for the first year following completion of the oral immunotherapy process. The next year the dose will be reduced to 8 peanuts once daily. Your child may also consume as much peanut as he/she would like in addition to the daily maintenance dose upon completion of the oral immunotherapy process. We will have regularly scheduled follow-up appointments, and if the time comes when the frequency of the maintenance dose changes, we will let you know. Until then, your child must continue the twice daily or daily maintenance dose.
I hope you find this information to be helpful. For a complete list of the peanut FAQ's be sure to visit the relevant page on the Dallas Allergy website. Link provided above.
Question 16: What if my child is sick and can’t take the doses on schedule?
A. If there is a gap of more than 15 hours between doses, call before giving the next dose. If it is less than 15 hours, pick up on the standard schedule.
Question 17: When can foods containing peanuts be introduced into the regular diet?
A. Foods containing peanuts may be introduced into the diet at the end of the oral immunotherapy process
Question 18: What is the goal of this process?
A. The number one goal is safety; to allow the patient to eat peanuts and foods that contain peanuts without thinking about it.