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patient education : 12069--Tree Nut- Food Challenge Appointment Guidelines

Information from Pediatric Allergy Clinic about how to prepare for your tree nut food challenge visit.

Handout File:

PDF document icon PE12069 Tree Nut Challenge.pdf — PDF document, 42 KB (43254 bytes)
  1. document content:


    • Be sure your child does not eat anything for 1 hour prior to the appointment.  Fluids are allowed.
    • Be prepared to stay for 2.5-3 hours.
    • Please be sure your child is off ALL antihistamines for a minimum of 72 hours (optimally, 1 week) before the food challenge visit.
    • Bring your epinephrine autoinjector (EpiPen/Auvi-q/Adrenaclick).
    • If your child is sick with fever or respiratory symptoms, or is having an eczema, allergy, or asthma flare, call our office (434-982-3654) before coming for your appointment.
    • Please call our office (434-982-3654) A MINIMUM OF 48 HOURS IN ADVANCE of your food challenge appointment if you are unable to keep the appointment.
    • Please read the specific food challenge instructions below. 

    Tree Nut Challenge

    • Please bring a commercial nut butter.  Futters Nut Butters is available online and provides uncontaminated tree nut butters. Bring your child’s favorite spoon and at least two options to eat with the nut butter, such as crackers, pretzel sticks, or bread.
    • Please also bring at least 2 or 3 options of either plain yogurt, pudding, plain mashed potatoes, or applesauce to mix with the peanut butter powder based on your child’s preference.    
    • Alternatively, if your child is old enough to eat whole nuts, you may purchase raw, whole tree nuts.  Trader Joe’s or your local health food store are good places to find individual, uncontaminated tree nuts.  Please bring the whole bag for the challenge. 
    • You may choose to soak the raw tree nut in water overnight and then puree the tree nut with water to create a smooth puree.  Bring at least 1 cup of the nut puree to your visit.


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