Dietary elimination and challenge protocol
A diagnostic standard used in clinical immunology and gastroenterology to pinpoint adverse food reactions. The process involves two key steps: the elimination phase, where suspected foods (such as milk, egg, wheat, soy, peanuts, or tree nuts) are strictly avoided for 2 to 6 weeks to achieve symptom resolution; followed by the challenge phase, where the eliminated foods are individually reintroduced in a controlled manner to see if symptoms recur.
Dosage by Body Weight
Elimination Phase: Strictly avoid all sources of the suspected food allergens. Check all food labels for hidden ingredients. Challenge Phase: Reintroduce one food at a time, starting with a very small portion (e.g., a crumb or a sip) and gradually increasing to a normal portion over 3 to 4 days, observing closely for reactions. Do not perform home challenges if there is a history of severe allergic reactions or anaphylaxis.
- Body Weight
- Below 5 kg
- Dose
- Maternal elimination diet or hypoallergenic formula
- Frequency
- Daily during elimination
- Tracking Notes
- For breastfed infants, the lactating parent eliminates the trigger food. For formula-fed infants, use amino acid-based formulas under pediatric guidance.
- Body Weight
- 5-7 kg
- Dose
- Maternal elimination or extensively hydrolyzed formula
- Frequency
- Daily during elimination
- Tracking Notes
- Closely monitor infant growth and symptoms under pediatric supervision.
- Body Weight
- 8-10 kg
- Dose
- Strict elimination of suspected solid foods
- Frequency
- Daily during elimination
- Tracking Notes
- Ensure alternative nutrient sources are provided to maintain adequate weight gain.
- Body Weight
- 11-15 kg
- Dose
- Strict elimination of suspected solid foods
- Frequency
- Daily during elimination
- Tracking Notes
- Challenge phase must be delayed if the child is currently sick or experiencing an asthma flare-up.
- Body Weight
- 16-20 kg
- Dose
- Strict elimination of suspected dietary triggers
- Frequency
- Daily during elimination
- Tracking Notes
- Keep a detailed food and symptom diary throughout both the elimination and challenge phases.
| Body Weight | Dose | Frequency | Tracking Notes |
|---|---|---|---|
| Below 5 kg | Maternal elimination diet or hypoallergenic formula | Daily during elimination | For breastfed infants, the lactating parent eliminates the trigger food. For formula-fed infants, use amino acid-based formulas under pediatric guidance. |
| 5-7 kg | Maternal elimination or extensively hydrolyzed formula | Daily during elimination | Closely monitor infant growth and symptoms under pediatric supervision. |
| 8-10 kg | Strict elimination of suspected solid foods | Daily during elimination | Ensure alternative nutrient sources are provided to maintain adequate weight gain. |
| 11-15 kg | Strict elimination of suspected solid foods | Daily during elimination | Challenge phase must be delayed if the child is currently sick or experiencing an asthma flare-up. |
| 16-20 kg | Strict elimination of suspected dietary triggers | Daily during elimination | Keep a detailed food and symptom diary throughout both the elimination and challenge phases. |
Formulation
Purpose
To systematically identify and confirm food allergies, food intolerances, or sensitivities by removing suspected triggers from the diet and systematically reintroducing them.
Generic Name
Dietary elimination and food challengeScheduled Drug
No. This medicine is generally not treated as a scheduled/prescription-only drug in common consumer references, but local rules may vary.