What Is Oral Immunotherapy (OIT) — And Will My Food Allergy Baby Need It?

With a food allergy baby to care for, the number of questions that run through your mind never shrinks, does it? How do I protect them from harmful allergens? What about the last reaction? How do I reintroduce that same allergen we avoided for so long?


The worries remain, and you want solutions. Let’s cover one of the possible solutions for reactivity, oral immunotherapy (OIT), and discuss how it may hold promise as a treatment option for some. As with many topics in the food allergy community, the medical field is divided, which can muddy the waters for parents.

OIT can help a baby who’s anaphylaxis to peanuts build enough tolerance to not die from exposure. Peanuts may still cause a reaction, but it’s no longer life-threatening. Similar to the ladders we recommend for reintroduction — it’s all about starting with small amounts. Slowly working your way up helps your child’s immune system shift its harsh response to allergens.


Free To Feed provides personalized guidance to help you make the best decision for your family. Our experts work with your child’s specific case so you can feel confident whether OIT is a good fit or not!


Let’s look closer at how oral immunotherapy works, who it works best for, and what research shows us.


Rising Food Allergies Mean Parents Are Looking For More Treatments


It won’t be the first or last time we say how often baby food allergies go underdiagnosed, and we know they’re on the rise. Data indicates that 1 in 13 kids suffer from life-threatening food allergies — and 40% of those children are reactive to more than one food! [1]Talk about a headache. This obviously causes stress on the entire family, especially with limited treatments.


Current strategies for food allergy babies are strict avoidance while breastfeeding, using specialty formulas, or withholding solids. As a parent, you need more options and we completely understand. But OIT isn’t for every food allergy baby.


Key Takeaway: OIT was designed for IgE-mediated food allergies.


If that just made your head spin, make sure to check out our blog on different types of food allergies here. IgE allergies can be confirmed through blood or skin prick tests, as well as your baby’s specific history and symptoms.


In 2020, the FDA approved the first peanut OIT therapy, a breakthrough for our food allergy community. As more treatments undergo different phases of research, it’s valuable to understand if this would be right for your family and what the data shows.


If your baby suffers from non-IgE-mediated food allergies, know Dr. Trill’s working hard to bring more solutions to the entire food allergy community. Free to Feed recommends Oral Food Challenges (OFC) during reintroduction for babies with non-IgE mediated allergies. It's also safer at home. And of course, the test strips work for all types of food allergies!


Factors that influence whether or not your child should try OIT?

  • IgE vs. Non-IgE Mediated Allergies

  • High Risk (Anaphylaxis)

  • Uncontrolled Asthma

  • Taste Aversions

  • Time Commitment

  • Language Barrier

  • & More


When deciding if OIT might be an option for your child, work closely with their medical provider and allergist. Keep in mind the time commitment with office visits, which isn’t always feasible for busy working families. And don’t be too hard on yourself if you try to go through it and your baby won’t even eat the food. It happens! (Annoying maybe, but some food allergies babies develop taste aversions from long periods of avoidance.)

How Oral Immunotherapy Works and What Research Shows


Oral immunotherapy isn’t always about “outgrowing” food allergies. It’s about allowing your baby to consume SOME of a food allergen without causing as serious of a reaction. Imagine hives versus not being able to breathe — huge difference.


OIT works by introducing a small amount of a specific food allergen into your child’s body (like milk or soy), often in a clinical setting.


The hope? Slowly, over time, your child’s immune system builds a threshold before a severe reaction occurs. It’s often referred to as desensitization.


Imagine giving your baby ONE peanut on Monday and waiting for a reaction. If no reaction, then you give another peanut on Tuesday, and so on. Eventually, you build up to 2 or 3 peanuts. And maybe the 4th peanut causes a reaction (scary and likely why most are done in a clinical setting). Believe it or not, this opens up the doors for many food allergy families, like being able to eat at a restaurant that serves peanuts or go to a birthday party without enormous amounts of fear.


But the real scenario doesn’t work like this. The amount of allergen begins at such a small amount, you wouldn’t be able to break up a peanut enough to do it. It’s a highly complicated and detailed process that should only be done by medical professionals. We’re happy to share a short video of an OIT journey with food allergy warrior, Ryder.





Sometimes it’s not about being able to eat peanuts. It’s about not dying from eating a peanut.


The medical field remains divided on how effective OIT is and if the risk is worth it to food allergy families. Let’s look at some OIT studies to see what the evidence shows.


  • A study found wheat oral immunotherapy resulted in successful desensitization. Like in our peanut example, desensitization doesn’t prevent a reaction. Rather, it limits the immune response so it's not as severe. This particular study found that higher dosing for longer periods of time helped desensitize the immune system more.[2]

  • Another study found that peanut oral immunotherapy caused an increased risk of allergic and anaphylactic reactions in older children. It’s important to note that the mean age in this study was 8-9-year-olds.[3] Because guess what?

  • Another study showed early peanut OIT introduction was highly successful at lowering specific peanut IgE levels. [4] (This proves that you can eat a peanut but not die from it!) The children in this study were younger than the previously mentioned one. Higher success starts earlier.


As always, more research in the food allergy community needs to be done! This touches the tip of the iceberg, and we get it. That’s why Free to Feed offers diverse experts and cutting-edge insight with complex issues like this.


Free To Feed Works With Your Family In All Areas Of Your Food Allergy Journey


Wherever you’re at in your food allergy journey, you’re not alone. From navigating the rough waters of finding your baby's triggers to deciding if oral immunotherapy might be an option for you, we’re here to support your family. Even though we don’t offer OIT — we support families with education and resources from all our experts on the team.


The information overload on food allergies can drive any sane person bonkers, honestly! Throw in a food allergy baby suffering from symptoms, and you’ll feel like it’ll never end. But there’s light at the end of the tunnel, and we provide you with the best resources out there.

Our registered dietician, Taylor, has first-hand experience with her son undergoing OIT for multiple food allergies. It required many office visits and wasn’t without worry. Her expertise in this area further supports our food allergy families. (So schedule your consultation with her if you’re considering OIT!)




For everything you need on your food allergy journey, consider our 3-month food allergy support package. Loaded with all the resources, support, and consults you’ll need to get answers and start moving forward!


Learn More Here!


References:

  1. https://www.foodallergy.org/resources/facts-and-statistics

  2. https://journals.lww.com/co-allergy/Abstract/2021/06000/Wheat_oral_immunotherapy.8.aspx

  3. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30420-9/fulltext

  4. https://www.jacionline.org/article/S0091-6749(20)31627-4/fulltext#secsectitle0065