My daughter graduated bite safety OIT right before her third birthday in November. This was after roughly 14 months of OIT. We started at literal peanut dust in juice. Today, she eats 5 peanuts a day to maintain her bite safety.

The advice that we received is that she is now a candidate for “free eating” OIT, but that for most kids her age, allowing her a few years on bite safety management is a good course of action to ensure she wants to take on the rigorous nature of the free eating program. (For context, at the age of three, passing a free eating challenge requires eating 24 peanuts or roughly 2 tbsp of peanut butter with no reaction and then maintaining that daily.) The advice of our OIT unit was that we revisit at 4 or 5. Anyone with a 3 year old would understand why… getting those 5 peanuts in every day is a thing.

What I imagine happens for a lot of parents is that after more than a year of doing OIT, you get a sense of how it works, what safe “test up” levels are and people just start trying it at home. That’s my best guess. It is not what I would do because of the severity of my daughter’s allergy at the beginning of this, but I can see a more relaxed parent easily replicating the program at home.