New approach to treat milk allergy in children

A new of its kind study published in the Journal of Pediatrics reports that structured protocol with extensively heated and baked milk promotes faster resolution of cow milk allergy(CMA).

Most children with milk allergy outgrow it, but only half do so by age 5 years. Studies show that for patients who can tolerate extensively heated and baked milk (EHBM), such as in muffins and cookies, regular consumption may speed resolution of food allergy.

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Adi Efron and his colleagues conducted a study to evaluate the efficacy and safety of a structured gradual exposure protocol (SGEP) with extensively heated and baked milk in promoting allergy resolution in children with cow milk allergy (CMA).

The case-control study included children with CMA aged 1-4 years who were treated with SGEP including extensively heated and baked milk who were compared with children treated with strict avoidance.

There were 43 children with milk allergy—26 (62%) males with a mean age at the intervention of 21 months who were treated with SGEP and followed to a mean age of 40 months. The median age at the resolution of CMA was compared with a matched group of 67 children treated with strict avoidance at least until 4 years of age or followed until earlier resolution, with a mean age at follow-up of 71 months.

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Key study findings:

• The median estimated age at CMA resolution in the SGEP group was 36 months compared with 98 months in controls.


• At last follow-up, 86% of treated children were tolerant to unheated milk proteins vs 52% of controls. By the end of the study, 86% of children in the exposure group had outgrown their milk allergy, compared to 52% of controls.


• Overall, 37% of patients in the exposure group had allergic reactions; although most were mild, 2 patients required epinephrine.

The study concluded that most milk-allergic children can tolerate EHBM and they should be encouraged to consume milk-containing baked items regularly.

For reference log on to https://doi.org/10.1016/j.jpeds.2018.07.091