Kaila et al. have surveyed current clinical practices regarding food challenges in Finnish paediatric hospitals with the aid of a questionnaire survey 1. In 75 % of the hospitals, food allergy to cow's milk or cereals was usually diagnosed using a clinical challenge test. The duration of the challenge varied from 0.5 to 7 days (median 4 days). Double-blind challenge testing was used only in seven of the hospitals, and in none routinely.
Kaila and Isolauri compared a double-blind food challenge to an open challenge in children, aged from 3 months to 6 years, with suspected milk allergy 2. The open challenge was positive, almost statistically significantly (p = 0.04), more often than the double-blind challenge (56 % vs. 44 %). The parental acceptance of a diagnosis of cow's milk allergy is higher with a double-blind challenge than a diagnosis that has been established with an open challenge.
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