Food Oral Immunotherapy (OIT)
Also known as: Food Oral Desensitisation • Food Allergy Desensitisation • Food Desensitisation
Food Oral Immunotherapy (OIT) is an evidence-based treatment that helps reduce allergic reactions to food through gradual, controlled exposure. It builds tolerance by regularly administering small but increasing amounts of the allergenic food, eventually reaching a maintenance dose.
Food oral immunotherapy is a medically supervised process where increasing amounts of the food allergen are introduced daily into the child’s diet to reduce the risk of allergic reactions following accidental exposure.
This approach has long been used for environmental allergies such as grass pollen, tree pollen, house dust mite and pet dander. Now, with a growing body of high-quality research, OIT is transforming care for children with food allergies.
Food allergies can place a heavy emotional and practical burden on families. Imagine not having to worry about your child reacting to accidental exposure to their food allergen.
OIT can provide hope and a proactive pathway forward, helping children:
Feel safer and more confident
Participate more freely in everyday life
Look ahead to a future with fewer allergy limitations
Oral Food Immunotherapy (OIT) at a Glance
Who is it for?
Children with IgE-mediated food allergy, typically 6 months – 4 years of age
Foods we treat
• Peanut
• Tree nuts (cashew, walnut, hazelnut, almond, Brazil nut, macadamia)
• Seeds (sesame, pumpkin seed, flaxseed / linseed, mustard seed)
• Legumes (green pea, yellow split pea, red lentil)
• Wheat
Specialised programmes
• Baked egg OIT (up until 11 years)
• Cow’s milk OIT (up until 11 years)
Typical treatment duration
Most children reach maintenance within 6–12 months
Programme support includes
• Consultant Paediatric Allergy supervision
• Specialist Paediatric Allergy Nurses
• Specialist Paediatric Dietitian guidance
• Structured up-dosing visits
• Weekday nurse helpline
• Email support 7 days a week
Our experience
Over 100 children treated with OIT without a single case of anaphylaxis
Oral Food Immunotherapy at Children’s Allergy Doctors
At Children’s Allergy Doctors, we offer food oral immunotherapy (food desensitisation) to:
peanut
Brazil nut
almond
macadamia
pumpkin seed
flaxseed / linseed
mustard seed
pea (green pea and yellow split pea)
lentil
wheat
in children up to 4 years of age.
The upper age limit for starting oral food immunotherapy is 4 years, as research shows this approach is safer in younger children, with fewer gastrointestinal side effects and a higher likelihood of achieving remission. Treatment may begin from as young as 6 months of age.
We also offer:
Baked egg oral immunotherapy and milk oral immunotherapy in children up to 11 years of age.
Watch the interview below to hear a parent’s perspective on food oral immunotherapy:
Sublingual Immunotherapy (SLIT) for Older Children
For children aged 5 years and above, we offer food sublingual immunotherapy (SLIT) to:
milk
egg
peanut
cashew
walnut
hazelnut
almond
sesame seed
SLIT has been shown to have fewer side effects (including a lower risk of anaphylaxis), particularly in older children.
Unlike oral food immunotherapy, SLIT does not require avoidance of sport or physical activity for two hours after the daily allergen dose, making it less restrictive for school-aged children.
Why Start OIT Early? (The Preschool Advantage)
Historically, research on food allergies and immunotherapy primarily centred around school-age children. However, recent evidence indicates that administering immunotherapy to preschool-age children leads to significantly higher success rates.
Administering immunotherapy during early immune system development may allow more effective modification of allergic immune responses.
Peanut oral immunotherapy studies in very young children have demonstrated particularly promising results.
Peanut OIT Research in Young Children
Peanut allergy is one of the most common food allergies and affects approximately one in 50 children in the UK. It is considered the leading cause of food allergy-related anaphylaxis.
Historically, families were advised to avoid all peanut exposure. However, strict avoidance is difficult, and accidental reactions occur in 7–14% of peanut-allergic individuals each year.
Increasingly, researchers are investigating early peanut oral immunotherapy, during the maturation of the immune system.
🥜 The IMPACT Study
In the landmark IMPACT study, researchers treated children aged 1–3 years with gradually increasing peanut exposure over two years. After stopping peanut for six months, the children underwent a peanut challenge.
In children aged 1–2 years, 71% were still able to tolerate peanut, indicating that their peanut allergy had entered remission.
This research supports the idea that early intervention may change the long-term trajectory of food allergy.
What Allergies Can Oral Immunotherapy Be Used For?
Oral desensitisation has been most extensively studied for:
milk
egg
peanut
However, there is increasing evidence supporting its use for:
sesame
tree nuts
seeds
legumes
wheat
It is important to understand that oral food immunotherapy requires ongoing dosing to maintain its benefit.
If dosing stops, the risk of reaction returns.
For this reason, OIT does not necessarily provide a permanent cure, but rather ongoing desensitisation and protection against accidental exposure.
Desensitisation should never be attempted without specialist supervision, as severe allergic reactions can occur.
How Effective is Food Oral Immunotherapy?
Numerous studies worldwide show that OIT is effective for:
milk
egg
peanut
tree nuts
sesame
Most studies report 80–90% desensitisation rates in children.
Importantly, research also shows significant improvements in quality of life for families.
The Oral Food Immunotherapy Process
The oral food immunotherapy treatment process involves gradually increasing the child’s exposure to the allergenic food protein in a controlled medical setting.
The programme is delivered in a Consultant-led multidisciplinary clinic.
Treatment begins with a very small dose of the food protein, which is gradually increased over time.
Evaluation
Before starting treatment, the child undergoes a thorough evaluation including:
assessment of food allergy history
overall health review
decision on how many allergens to treat simultaneously
Families are advised to avoid the allergen and ensure emergency medication such as an adrenaline auto-injector is available.
Baseline allergy tests (within 6 months of starting OIT) are required to ensure the child is still allergic to the food allergen:
skin prick tests
blood tests (specific IgE)
- where necessary an oral food challenge
Suitability & Education Appointment
Our specialist OIT meet before committing to the program to discuss
- explain the bespoke protocol in detail
- explore with parents how OIT will be incorporated into daily life
Dietetic Training Appointment
Our specialist paediatric allergy dietitian meets with both parents to:
teach dose preparation and administration
provide practical support
Initial Dose
The first dose is given in the Consultant-led clinic, with monitoring for 1–2 hours.
Dose Escalation
Doses are increased every 2–4 weeks in clinic.
This continues until the maintenance dose of approximately 300 mg allergen protein is reached.
Maintenance Dose
Once the maintenance dose is reached, the child continues taking this amount daily to maintain protection.
Monitoring
A virtual specialist dietetic ort nurse consultation at 6 months helps review progress and adherence to the OIT “Golden Rules”.
Support
Families receive:
7-day OIT email support
nurse helpline Monday–Friday
If reactions occur, doses may be adjusted.
Follow-Up
At 1 year, allergy tests are repeated and a supervised feed / oral food challenge may be performed.
Longer-Term Dosing
After 3 years of maintenance dosing, many children can reduce dosing to three times per week.
Milk and Baked Egg Oral Immunotherapy
Egg allergy often resolves naturally in childhood but can persist.
For children unable to tolerate baked egg during supervised challenge, baked egg oral immunotherapy can begin using baked products.
The programme includes 6 up-dosing visits in the Consultant-led clinic.
After one year of maintenance dosing, a supervised challenge to boiled egg may be performed.
Milk allergy can also persist in some children.
Milk OIT begins with fresh milk dosing.
The programme includes 3 clinic up-dosing visits, followed by home up-dosing in very small increments up to 3 ml of neat cow’s milk.
How Safe is Oral Food Immunotherapy?
OIT is considered safe when delivered under the supervision of a Consultant-led multidisciplinary allergy team.
Common side effects include:
abdominal pain
nausea
vomiting
oral itching
throat itching
hives
Rarely, more serious reactions including anaphylaxis may occur.
Benefits of Oral Food Immunotherapy
Potential benefits include:
Increased tolerance to allergenic foods
Reduced risk of accidental reactions
Improved quality of life
Reduced reliance on emergency medication
Improved social and psychological wellbeing
Support During the Programme
Families receive ongoing support including:
regular clinic visits
specialist dietetic advice
practical guidance
psychological support resources
educational materials for parents and children
What is the cost of oral food immunotherapy?
Suitability for oral immunotherapy (OIT) is usually discussed during your child’s routine consultation when a food allergy diagnosis is made. If your child has had recent allergy testing elsewhere, it is helpful to provide this in advance. This initial consultation, along with any allergy testing or food challenges required, will be billed at the standard outpatient consultation rate.
As a treatment for allergy, food allergy desensitisation is not usually covered by health insurance, which typically only covers the diagnosis of allergy.
Our oral food immunotherapy programme is delivered as a structured clinical pathway rather than being billed per individual appointment.
The programme fee reflects the comprehensive support provided throughout treatment, including:
Consultant Paediatric Allergy supervision
- Provision of equipment for weighing and administering OIT doses
Specific training appointment on how to make up and administer OIT doses
Reserved clinical time for initiation and up-dosing visits
Additional up-dosing visits if required due to reactions or missed doses
Specialist paediatric allergy nursing and dietetic support
Ongoing clinical guidance throughout the up-dosing phase
Weekday Clinical Nurse Specialist helpline
Email support seven days a week
Six-month maintenance telephone review
Administrative coordination of the programme
Programme Fees
Suitability & Education Appointment: £250
(required before starting treatment)
OIT Programme Delivery Fee
Single food allergen: £6,000–£9,000
Two food allergens: £9,500
Three food allergens: £12,000
Four food allergens: £14,500
Up to four foods can be treated simultaneously, where clinically appropriate.
Payment by instalment is available.
OIT uses real food sourced from supermarkets or online retailers, which parents purchase themselves for treatment. These foods have been carefully analysed for their allergen protein content to ensure accurate dosing.
Follow-up after treatment
We recommend annual follow-up reviews after completion of the programme. These appointments may include a supervised feed to assess how much of the allergenic food your child can tolerate. Follow-up appointments are not included in the programme fee.
These reviews allow families to see the benefits of treatment and provide reassurance that their child can tolerate a greater amount of the allergen, helping reduce anxiety around accidental exposure and improving confidence in everyday situations.
Helping Children with Food Allergies Live Freer, Safer Lives: Our OIT Service Results
Between March 2022 and March 2025, we audited 73 children (aged 6 months to 5 years) who were treated with OIT to peanut, tree nuts, sesame, milk, and baked egg.
🌟 Outstanding Safety Results
Your child’s safety is always our number one priority.
- No child experienced anaphylaxis from an OIT dose.
- No child needed/was administered an adrenaline (EpiPen) after an OIT dose.
- No child was admitted to hospital because of an OIT dose.
- No child had a severe adverse reaction due to their OIT.
This shows that OIT, when delivered by a specialist team, is safe even in very young children.
📈 Strong Progress with OIT
Many children are already benefiting from protection:
- With multiple food OIT, 53% have reached their maintenance dose (and the rest are still progressing).
- With single food OIT, 69% have reached their maintenance dose (and the rest are still progressing).
❌ Why Some Families Stopped OIT
For the few children who discontinued OIT, the reasons were not usually related to the treatment itself:
- 4 children found the first dose difficult (on the higher-dose peanut Bamba™ protocol) and their families decided not to restart.
- 4 children had ongoing illnesses which made it hard to continue.
- 3 children moved abroad and could not carry on treatment.
- 2 children were lost to follow-up.
- Only 1 child stopped because of side effects directly from OIT.
This means that for the vast majority, OIT was both tolerable and safe.
🥜 Real-Life Protection
Every child who has undergone supervised food challenges during maintenance has been able to eat their allergen successfully – proving they are desensitised and protected.
💛 What This Means for Families
Parents consistently tell us that OIT has transformed their lives. We reviewed parental quality of life, and once their child reaches the maintenance stage, parents enjoy:
- Peace of mind knowing the risk of severe reactions is dramatically reduced.
- Freedom from constant fear of accidental exposure.
- Greater inclusion at birthday parties, playdates, and school events.
- Less worry and anxiety for the whole family.
✨ At Children’s Allergy Doctors, our mission is to empower families to live with confidence. OIT is one of the most exciting and life-changing tools we have to make that happen.
If you have any further questions, please contact our practice team on 0203 146 7721 or email admin@childrensallergydoctors.com.
What parents say:
‘We have been seeing Dr Helen Brough and her team at Children’s Allergy doctors now for 6 years and I could not recommend them more highly. They have always made me feel so confident with my son’s allergies and always respond so quickly if needed.’
‘We had an excellent experience with Helen Brough at The Portland Hospital. My daughter has had multiple food allergies for several years, and finding the right specialist was very important to us. From the very beginning, Professor Helen Brough and her entire team were incredibly friendly, supportive, and professional. They made us feel comfortable and reassured at every appointment.
What truly stands out is how responsive and helpful the team is. They always answer phone calls and emails very quickly, and they are supportive in every situation. As parents of a child with multiple allergies, this level of communication means so much.
Since starting treatment with Professor Brough, we have seen amazing progress. Within a year, my daughter can now eat many foods that were previously unsafe for her. She is now able to have boiled and baked eggs, some nuts, baked milk, and even hard cheeses. This has made a huge difference in her daily life and confidence. We are extremely grateful for the care, guidance, and expertise we have received. I highly recommend Professor Helen Brough to any parent looking for an experienced, knowledgeable, and compassionate allergy specialist.’
‘We would highly recommend Professor Brough and the team at Children’s Allergy Doctors for their professionalism and kindness. We’ve felt in safe hands throughout our years there, during which our daughter has successfully become desensitized to peanut, walnut, and cashew from initially fairly severe allergies.’
Speak to Our Team
If you would like to discuss food immunotherapy for your child, our team would be happy to help.
📞 0203 146 7721
📧 admin@childrensallergydoctors.com
If you have any further questions, please contact our practice team on 0203 146 7721 or email admin@childrensallergydoctors.com.