Neva and Nathaniel Wallace on their first day of school in Colombia in summer 2023. The extra protection they have from OIT has enabled their family to travel with more confidence and worry less about food.
For many parents, navigating the world of food allergies can be a challenge. For Courtney Wallace, this journey began when her daughter, Neva, broke out in hives after eating a peanut butter and jelly sandwich at just 18 months old. Now, years later, both Neva and her younger brother, Nathaniel, are participating in Akron Children’s Oral Immunotherapy (OIT) program, a pioneering approach that’s giving their family newfound peace of mind. But the road to managing these life-threatening allergies is anything but easy—it’s a commitment that requires dedication and the support of a compassionate medical team.
“About 4 years ago the FDA approved a peanut-based OIT product called Palforzia and our allergist, Dr. Lisa Sammon, introduced me to it,” said Courtney.
According to Dr. Sammon, OIT is one of the newer therapies allergists use to manage food allergies.
Neva is pictured here on her very first day of OIT at Akron Children’s.
“OIT involves taking micro-doses of one’s allergen daily which is gradually increased according to a schedule with the hope of preventing severe reactions upon accidental exposure,” she said. “Some patients may be able to tolerate more than their daily maintenance dose, which is another exciting benefit of OIT, but it is not a guaranteed cure.
“OIT is best suited for younger or preschool-aged patients because overall, as an age group, they experience less side effects,” she added.
Neva, age 8, has participated in Akron Children’s OIT program for her peanut allergy for the past two years. Nathaniel, age 5, began OIT in Dec. 2023 for his tree nut allergy. He was the very first patient enrolled in Akron Children’s cashew OIT program.
OIT requires a big commitment from families, including following a strict, at-home regimen for daily OIT dosing.
Courtney was in the habit of carrying epipens and antihistamines with her everywhere she went, but she still worried when the kids weren’t in her care. While the idea of feeding her kids their allergen was initially quite scary, she has come to appreciate the extra layer of protection OIT offers her kids.
“My husband was going on sabbatical, and we were going to be traveling and living in Colombia, South America, so I felt like we would have less control over our food,” said Courtney.
While participating in OIT has decreased her anxiety about accidental exposures, Courtney said it’s also a lot of work on her part.
Neva, Nathaniel and their big brother, Theo, on vacation in Ecuador.
“This isn’t something you just do once at the doctor’s office,” she said. “It’s a big commitment from families, including regular bi-weekly appointments that can last months (Nathaniel has had 17 in total) and following a strict, at-home regimen for daily OIT dosing.
“I have to make sure the kids stay calm after their dosing,” said Courtney, who has even had to check in with the kids’ teachers to make sure they don’t have gym class, or a physical activity planned too close to their dosing regimen. “No exercise, running, jumping or bathing for 1 hour before and at least 2 hours after the dose, because it can lower the threshold for anaphylaxis.”
When the Wallaces first began their OIT journey, Dr. Sammon’s staff helped Courtney weigh and measure her at-home doses. They even gave her a food scale.
Both Nathaniel and Neva are currently on maintenance doses (2000 mg of protein) – which equals about 9 peanuts for Neva and 6 cashews for Nathaniel. Courtney knows they can stop OIT at any time, but if they do, they risk losing OIT’s protective benefit.
Both Nathaniel and Neva are currently on maintenance doses (2000 mg of protein) – which equals about 9 peanuts for Neva and 6 cashews for Nathaniel. Since both the kids have done so well on OIT, they will complete food challenges in the fall.
“OIT is a long term therapy. Ideally, the patient should plan to maintain the allergenic food in their diet on a regular basis to prevent unnecessary reactions,” said Dr. Sammon. “The longer someone is compliant with OIT therapy, allergists may reduce dosing frequency on a case-by-case basis.”
“I’m so thankful for the allergy team at Akron Children’s,” said Courtney. “They are exceptional. They always respond to my MyChart messages. They make you feel so cared for.”
Since both the kids have done so well on OIT, they will complete food challenges in the fall.
“After a set time on OIT, patients can undergo food challenges to determine if they can tolerate higher amounts of the allergen,” said Dr. Sammon. “This gives patients the option to consume more than the standard maintenance dose and provides greater flexibility with food options should they pass the challenge.
“OIT can be a life-changing therapy for patients with nut allergies and Akron Children’s is proud to be on the cutting edge of this therapy,” she added.
Learn more about OIT at Akron Children’s.
