“We don’t have to be perfect all the time.”
How one family’s journey with oral immunotherapy gave them greater peace of mind—and how Summit Health is helping other families do the same.
For Melissa Czerwinski and her daughter, Lindsay, leaving the house has always meant one last mental checklist: phones, keys and an EpiPen.
Ever since Lindsay developed food allergies shortly after her first birthday, everyday outings have required careful planning. Birthday parties, school events, vacations and even grabbing ice cream with friends came with extra questions, careful label reading and the constant worry that one accidental bite could lead to a serious allergic reaction.
“I think food allergies have always caused us anxiety and inconvenience,” Melissa says. “Kids with food allergies don’t just go to a birthday party. They don’t just go to a restaurant. My daughter had never been to a bakery before.”
As Lindsay grew into a teenager, Melissa’s concerns shifted from managing her daughter’s allergies herself to preparing her for the day Lindsay would be navigating the world on her own. An athlete with dreams of college, Lindsay wanted the confidence to enjoy greater independence.
“I kept thinking about what this would look like when she went to college,” Melissa says. “I can’t always be there to monitor everything. It was scary.”
Looking for a way to help reduce that fear, the Czerwinski family turned to Summit Health’s Oral Immunotherapy (OIT) program. While there is currently no cure, OIT can help reduce the risk of severe reactions from accidental exposures and give the 1 in 13 kids living with food allergies in the U.S. greater confidence in everyday life.
At Summit Health, allergists offer OIT for children as young as 1 year old with common food allergies including peanut, select tree nuts (cashew, walnut, hazelnut, almond), sesame, milk, and egg. The treatment gradually introduces small amounts of the allergen under close medical supervision, helping children become desensitized over time. While OIT does not eliminate the allergy, it creates a safety buffer against accidental exposures.
“Many parents spend years worrying about every bite their child takes,” says Gary Pien, MD, allergist and immunologist at Summit Health. “Oral immunotherapy can provide peace of mind by reducing the risks associated with accidental exposures. It’s not a cure, but it can help families reduce the stress of managing food allergies.”
How Does Oral Immunotherapy Work?
Oral immunotherapy helps desensitize children to a food they are allergic to. Under the supervision of an allergist, children receive carefully measured amounts of the allergen—sometimes as little as 1/500th of a nut. The amount is gradually increased over time based on how well they tolerate treatment.
As the body becomes more accustomed to the allergen, it can tolerate larger amounts before a reaction occurs. This process, called desensitization, helps reduce the risk of a severe reaction from a small accidental exposure.
“OIT helps make life more ‘bite safe,’” says Kerry LeBenger, MD, an allergist and immunologist at Summit Health. “The goal is not for patients to freely eat foods they’re allergic to. The goal is to help protect them if they accidentally come into contact with that food.”
What Does the Treatment Process Look Like at Summit Health?
The first step is an evaluation with an allergist to determine whether OIT is the right option for your child.
Initial treatment begins at Summit Health’s dedicated infusion center in Berkeley Heights, where the initial doses are given under close supervision. During this visit, which typically lasts about 3-4 hours, a nurse and allergist carefully monitor your child the entire time. Once a child finishes their starting doses at the infusion center, they continue taking that same amount at home every day.
Patients return to their allergist’s office every two weeks for monitored up dosing visits, where the amount of allergen is gradually increased over a 6-month period until they reach their maintenance dose. Roughly 80% of children are able to complete the protocol and eat one daily peanut M&M or tree nut to maintain their desensitized state.
“Our team is with families every step of the way,” says Dr. Pien. “We carefully monitor patients, answer questions and adjust treatment when needed. Parents are never navigating this process alone, and families are often surprised by how manageable the process is.”
For Melissa, the first treatment day was emotional. “We walked in thinking, ‘We’re going to purposely give her something we’ve spent years avoiding,’” she says. “It was really scary.”
Lindsay experienced a mild itchy throat during her first visit, but Melissa says the care team immediately put the family at ease.
“They were so calm,” she recalls. “Her throat became itchy, but they had her eat a snack and waited 15 minutes. That was the only reaction she ever had.”
“Our team is with families every step of the way,” says Dr. Pien. “We carefully monitor patients, answer questions and adjust treatment when needed. Parents are never navigating this process alone.”
“It’s an everyday commitment,” she says. “People should really think about whether they’re ready for that. But it gets easier, and for us it’s absolutely been worth it.”
Getting Started Sooner
Many OIT programs have lengthy waiting lists. At Summit Health, children can often be evaluated within days and begin treatment shortly afterward if OIT is appropriate.
“We want parents to know they don’t necessarily have to wait months to explore this option,” says Ami Shah, MD, allergist and immunologist at Summit Health. “In many cases, we can evaluate patients and begin treatment much more quickly.”
What Are the Risks and Benefits?
Most children tolerate OIT well, though side effects such as stomach discomfort, nausea, vomiting, itchy throat, congestion and itchy eyes can occur. Because serious reactions, including anaphylaxis, are possible, treatment should always be performed under the supervision of an experienced allergy team. Families should continue carrying epinephrine throughout treatment.
Today, Lindsay has successfully completed her first round of oral immunotherapy for her cashew allergy and continues taking a daily maintenance dose. She is allergic to four tree nuts, and this fall she will begin treatment for her walnut and pecan allergies.
“It’s brought our anxiety down a lot,” Melissa says. “We don’t have to be perfect all the time. It leaves room for error if she accidentally comes into contact with something. Just having cashews in our house now is something I never imagined. It gives us protection and peace of mind.”
The family is already looking forward to milestones they once thought might never happen.
“Our celebration after the next round is going to a bakery and an ice cream shop,” Melissa says. “Those are things she’s never been able to experience.”
As Lindsay prepares for college, Melissa says she’s already beginning to feel more confident about the future.
For many families, the greatest benefit of OIT is greater peace of mind, increased confidence and added protection against accidental exposures.
Is OIT Right for Your Child?
OIT may be an option for children as young as 1 year old with a diagnosed food allergy. It is not a cure, and most patients continue a daily maintenance dose while avoiding their allergen, reading food labels and carrying epinephrine.
“Parents often assume they simply have to wait and hope their child outgrows the allergy,” says Dr. Pien. “For many families, oral immunotherapy offers another path that can reduce anxiety and improve confidence in daily life.”
Melissa hopes other parents know they’re not alone.
“It was really scary, and that’s completely understandable,” she says. “But be brave. We were brave, we got over that first hurdle, and it’s worth it.”
How Summit Health Can Help
If your child has a food allergy, schedule an appointment with a Summit Health allergist to learn whether oral immunotherapy is right for your family. Together, you can decide on the best treatment plan to help your child safely navigate life with greater confidence.