top of page

My Peanut Challenge

Please bring one or all of the following items:


  • At least three (3) tablespoons of creamy peanut butter. You may bring a bread or crackers the patient tolerates to top with peanut butter, if the patient refuses to take it straight from a spoon.  You also may bring a semi-solid food the patient tolerates to mix with peanut butter, such as yogurt, pudding, applesauce, oatmeal, or other pureed cereal.  Peanut Butter & Co. has different flavors of peanut butter not contaminated by tree nuts (

  • Peanut butter powder (ex. PB2, PBfit, or TruNut). MUST bring a semi-solid food the patient already tolerates to mix with the powder (see above).

  • Two (2) standard size Reese’s Peanut Butter cups (if not allergic to milk), NOT giant or mini cups or other brands.

  • Three (3) Justin's milk chocolate peanut butter cups (if not allergic to milk, soy, or tree nuts) or Justin's dark chocloate peanut butter cups (if not allergic to soy).

  • For very young patients, it is okay to bring Bamba peanut snacks.




Can we have a Food Challenge if the patient is sick?

If the patient has a fever, flu-like symptoms, cough, wheeze, hives, worsened eczema, widespread rash, throat symptoms, vomiting, or other significant illness symptoms, the procedure will most likely not be done.  Please contact the office to discuss symptoms and reschedule the challenge if needed.  You may also keep the appointment to have a full illness assessment and to determine if the food challenge should be cancelled.


Food Challenge guidelines and what to expect

  • Please stop using antihistamines beginning 3 days prior to appointment. There is no need to stop asthma medications or nasal steroid sprays. Please call the office if you are unsure what medications to stop.

  • No food should be given to the patient 2 hours before arriving for challenge. Clear liquids are okay.

  • Please be prepared for the challenge appointment to last 2 to 4 hours.

  • The patient will be given small, increasing doses of the product every 15 minutes until a full serving size has been ingested. We will watch closely for any signs of a reaction, and vital signs will be taken before each dose and for an observation period after the last dose.


What are the risks of having a Food Challenge?

An allergic reaction may happen. The reaction may be similar to the patient’s first reaction or it could include new symptoms. Symptoms may include hives, swelling, shortness of breath, wheezing, coughing, vomiting, or diarrhea.


What happens if patient has a reaction?

The practitioner will examine the patient, and depending on symptoms, medications may be given such as antihistamine, anti-inflammatory steroid, or an epinephrine injection in the thigh. The patient will stay extra time for observation until stable to leave the office.


Expectations after passed challenge

  • Patient will be cleared to eat food item 24 hours after challenge is completed.

  • The food should be included in patient’s diet at least once a week or as directed by the practitioner.

  • Follow up with your practitioner with any other questions or concerns.

bottom of page