In the Journals

Baked cow's milk food challenge relatively safe for children with cow's milk allergy

Children with cow’s milk allergy had relatively safe reactions to an oral food challenge of baked cow’s milk, according to recent study results.

Dianne E. Campbell, MB, BS, FRACP, PhD, chair of pediatric allergy and clinical immunology, the Children's Hospital at Westmead, Sydney, Australia, and colleagues studied 70 children with cow’s milk allergy (CMA; median age, 5.3 years) who presented at a tertiary clinic from 2010 to 2013 with complete cow’s milk (CM) avoidance. Thirty-four percent had a history of anaphylaxis to CM, 59% were diagnosed with asthma, and 33% used an asthma preventer. A baked CM oral food challenge (OFC) was conducted, with incremental dosages totaling one baked muffin.

Dianne E. Campbell, MB, BS, FRACP, PhD

Dianne E. Campbell

OFC was successful in 51 children (30 boys) who incorporated baked CM into their diets, while the others (11 boys) had a reaction to the challenge, including anaphylaxis in four children that required intramuscular adrenaline.

Asthma, asthma requiring preventer therapy, IgE-mediated reactions to more than three food groups, and patients with a history of CM anaphylaxis predicted clinical reaction to baked CM.

“This study has shown the relative safety of an OFC to baked CM in children with CMA, including those with a previous reaction to baked CM or anaphylaxis to whole CM,” the researchers concluded. “The authors recommend that the initial introduction of baked CM should occur under direct medical supervision in an environment where severe reactions can be managed appropriately. Particular caution should be exercised in those children with CMA who have a combination of asthma, multiple food allergies, and a history of anaphylaxis to CM and other foods.”

 

Disclosure: Paul J. Turner, PhD, reports receiving support from the UK Medical Research Council and the National Institute for Health Research Imperial Biomedical Research Centre.

Children with cow’s milk allergy had relatively safe reactions to an oral food challenge of baked cow’s milk, according to recent study results.

Dianne E. Campbell, MB, BS, FRACP, PhD, chair of pediatric allergy and clinical immunology, the Children's Hospital at Westmead, Sydney, Australia, and colleagues studied 70 children with cow’s milk allergy (CMA; median age, 5.3 years) who presented at a tertiary clinic from 2010 to 2013 with complete cow’s milk (CM) avoidance. Thirty-four percent had a history of anaphylaxis to CM, 59% were diagnosed with asthma, and 33% used an asthma preventer. A baked CM oral food challenge (OFC) was conducted, with incremental dosages totaling one baked muffin.

Dianne E. Campbell, MB, BS, FRACP, PhD

Dianne E. Campbell

OFC was successful in 51 children (30 boys) who incorporated baked CM into their diets, while the others (11 boys) had a reaction to the challenge, including anaphylaxis in four children that required intramuscular adrenaline.

Asthma, asthma requiring preventer therapy, IgE-mediated reactions to more than three food groups, and patients with a history of CM anaphylaxis predicted clinical reaction to baked CM.

“This study has shown the relative safety of an OFC to baked CM in children with CMA, including those with a previous reaction to baked CM or anaphylaxis to whole CM,” the researchers concluded. “The authors recommend that the initial introduction of baked CM should occur under direct medical supervision in an environment where severe reactions can be managed appropriately. Particular caution should be exercised in those children with CMA who have a combination of asthma, multiple food allergies, and a history of anaphylaxis to CM and other foods.”

 

Disclosure: Paul J. Turner, PhD, reports receiving support from the UK Medical Research Council and the National Institute for Health Research Imperial Biomedical Research Centre.