Children with persistent food allergies to dairy products, eggs and tree nuts will now be able to eat such foods without adverse reactions once they complete the Food Oral Immunotherapy (FOI) programme started by National University Hospital.

The Food Oral Immunotherapy (FOI) programme is the first allergy treatment programme for children in Singapore. Started by the National University Hospital in August last year, it has had five patients ‘graduate’ after treatment for peanut allergy. Currently, there are 14 children undergoing FOI, with one child being treated for allergy to cow’s milk.


Life as a parent of a child with food allergies can be a nightmare. When your little one suffers from a food allergy, everyone in the family faces a psychological burden as well. You have to constantly be on the watch, checking ingredient labels and scrutinising menus. Even then, complete avoidance isn’t always possible as eggs, milk and tree nuts can be hidden in many foods.

(See also: Choosing An Allergy Test – The Lowdown)

Now There’s a Treatment to Control Food Allergies in Kids

If you’ve always wished for a treatment that can control food allergies in your child, rejoice! The Food Oral Immunotherapy (FOI) programme started at National University Hospital (NUH) in August 2015 will allow young allergy sufferers to consume trigger foods without adverse reactions. That’s provided they successfully complete the programme, of course. The best part? There’s no need for medication at all!

How Does This Treatment Control Food Allergies in Children?

Peanut Butter on Bread with Peanuts

FOI, the first such allergy treatment programme for children in Singapore, works by increasing a person’s threshold of reaction to an allergen. Simply put, the immune system is taught to tolerate greater and greater amounts of allergen. Think of it as a vaccine of some sort. For example, a child who would suffer anaphylaxis (an acute allergic reaction to an allergen) upon ingestion of a fraction of a peanut can raise that threshold of reaction to 10, 20 or even more peanuts.

The programme lasts from six months to a year, and is suitable for children from five years of age. It costs between $5,000 and $9,000, before government subsidies.

If you’re keen on registering your child, here’s what to expect from start to end:

  1. A clinic consultation involving your child and the rest of your family members
  2. A baseline food challenge: your child will ingest a minuscule amount of food allergen to confirm an allergy
  3. The first dose performed under supervision of medical staff followed by two hours of observation
  4. The same dose of allergen to be taken once a day at home by your child under supervision
  5. An increase in dose every fortnight; with a compulsory visit to the hospital, followed by two hours of observation
  6. The end of the programme: your child will take the allergen in the form and dose he chooses at least twice a week to maintain its effect

Would There Be Any Adverse Effects?

By now, you’ve probably got a pressing question on your mind: “But how safe is this FOI programme?” According to Dr Soh Jian Yi (below, right), Consultant at the Division of Paediatric Allergy, Immunology and Rheumatology who spearheaded the treatment, there are risks during and after the programme. “Occasional mild reactions during the treatment are possible, but they are normal,” he assures.

However, if older children decide to flout the rules following completion of FOI – by not sticking to their chosen dose of allergen for instance – they could still suffer severe reactions. Looks like it’s a matter of discipline, then!

Not Convinced? This Success Story Will Give You Hope!

Shih Kai, his father and Dr. SohImage: National University Hospital.

One young man has been diligently sticking to his allergen consumption regime since completing the FOI programme in October last year. Thirteen-year-old Tng Shih Kai (above, centre) first suffered an allergic reaction to peanuts when he was about one-and-a-half years old. About a decade later, he started FOI at NUH in January 2016.

“We wanted to complete FOI in 2016 because Shih Kai would be starting secondary school this year. That means more activities to attend outside of school as well as socialising with his peers. We did not want his allergy to affect his dietary options,” explains his father, Tng Yan Hui (above, left). Seems legit to us. No teen would want to watch on as his friends enjoy satay dipped in peanut sauce – one of Shih Kai’s previous gripes!

Has FOI worked for Shih Kai? Most definitely. The teen can now enjoy a Snickers bar without having to worry about an allergic reaction. Shih Kai is one of five young patients who have finished the FOI programme for peanut allergy. There are 14 children who are currently undergoing FOI, with one child being treated for allergy to cow’s milk. A similar treatment for those with shellfish allergy is in the pipeline.

Want to find out more? Check here or e-mail allergy_kids@nuhs.edu.sg

(See also: Peanut Allergy in Singaporeans)