Pediatric Allergy Oral Immunotherapy (OIT) Program

Food oral immunotherapy (OIT) is a method of allowing food allergic patients to become less reactive to specific allergenic food. OIT is done by giving small amounts of a food over time to try to make the body less reactive to it. Patients are scheduled every two weeks for dose-escalation visits and take the same dose of food at home between visits. 

Our OIT program is located at our Sunnyvale location and is available only to pediatric patients who have established care with one of our pediatric allergists. We currently have a waiting list for patients to join the OIT program. If your child was previously treated at the Sean N. Parker Center for Allergy & Asthma Research, please contact them and request that they send a referral to us to establish care and to determine if we are able to continue OIT treatment. Please note that continuation of additional therapies such as Xolair may not be an option.

Why do patients choose to do OIT?

  • To prevent or decrease the severity of allergic reactions after accidental ingestion.
  • To feel more comfortable with “may contain” labeling on packaged foods.
  • To feel more comfortable eating at restaurants or in other social settings.

What are the limitations of OIT?

  • OIT is not a cure. Desensitization to the food usually goes away when treatment is stopped.
  • OIT does not allow the allergenic food to be eaten in unlimited amounts. Patients should not exceed their normal daily dose.
  • Participating in OIT does not mean you can stop carrying epinephrine auto-injectors. Patients must continue to carry emergency medications during OIT at all times.

How does OIT work?

Patients receive a small dose of a food in the clinic and are observed for at least an hour. Every day for the following two weeks, the patient continues to take that same dose at home. Two weeks later, the patient returns to the clinic and receives a slightly higher dose. Again, the patient is observed in the clinic for at least an hour and then continues taking that dose daily at home. These biweekly visits continue for approximately six to 10 months until the goal dose of the allergenic food can be tolerated. Patients continue taking this maintenance dose every day at home.

What are the risks of OIT?

The most common side effects of OIT are mild and include mouth itching, throat itching, mild abdominal pain or cramping, and mild rash. There is a risk of more severe side effects, such as severe abdominal pain, vomiting, difficulty breathing, or wheezing.

The threshold for reacting to an allergen is lowered when the body is stressed. Examples include illness, high altitude, and international flights. If this occurs, contact your child’s care team on how to adjust the OIT dose.

Anaphylaxis and severe reactions such as vomiting, severe abdominal pain, and difficulty breathing can occur. Because the patient is eating the food they are allergic to, there is always the chance that they may have an anaphylactic reaction to the food. Patients on OIT must continue to carry their epinephrine auto-injector at all times.

Some patients on OIT have developed eosinophilic esophagitis (EOE), chronic inflammation of the esophagus. EOE can cause chronic abdominal symptoms such as nausea, cramping, vomiting, and difficulty swallowing. Symptoms of EOE should be evaluated by a gastroenterologist; the symptoms of EOE usually go away when OIT is stopped.

OIT may not be the best treatment for your child if:

  • You or your child have extreme anxiety about ingesting the allergen.
  • You or your child are hesitant to use an epinephrine auto-injector.
  • Your child has asthma or other medical conditions that are not under good control.

How much does OIT cost?

We are unable to supply the food and flours used for all OIT doses, so families are responsible for purchasing the foods and flours. Each OIT clinic visit is billed to the patient’s insurance, and families are responsible for paying all visit copays. Because each insurance plan varies in coverage and copay amount, we are unable to estimate the cost of OIT treatment.