Q:

11/5/2012
21 month old with GERD, esophageal dysmotility, developmental delay. Has had feeding issues re: textures and most calories via G tube with Compleat Pediatric, which list sodium caseinate as seventh ingredient. Started vomiting after eating yogurt, at times during feeding, other times after its ingestion. Hasn't had other frank milk products since. No other allergy end organ symptoms. Milk PST wheal 5mm, Milk sp IgE immunocap: 1.62. I haven't been able to find reports of food challenges via gastrostomy tube. Has it been done? Special considerations or alterations in procedure of food challenge?

A:

Thank you for your inquiry.

I am forwarding your question to Dr. Amal Assa’ad, who is a nationally known expert in food allergy, and a coauthor of the Academy’s Work Group Report “Oral Food Challenge Testing” (J Allergy Clin Immunol 2009 (June); 123(6):S365-S383.

As soon as we receive Dr. Assa’ad’s response, we will forward it to you.

Thank you again for your inquiry.

Sincerely,
Phil Lieberman, M.D.

We received a response from Dr. Amal Assa'ad regarding your Ask the Expert inquiry. Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

Response from Dr. Amal Assa'ad:
Yes, I have done challenges through feeding tubes and Gtubes. They are done the same way as an oral challenge as regards amounts and time intervals.

Amal Assa'ad

AAAAI - American Academy of Allergy Asthma & Immunology