Long-Term Follow-Up After Baked Milk Introduction

Area of Science:

• Allergy and Immunology
• Pediatric Gastroenterology

Background:

• Clinical trials show baked milk (BM) introduction accelerates milk allergy resolution.
• Real-world, long-term data on BM introduction are scarce.

Purpose of the Study:

• To characterize clinical experiences with BM introduction.
• To evaluate outcomes and adverse reactions following BM oral food challenges.

Main Methods:

• Retrospective chart review of BM oral food challenges (2009-2014).
• Minimum follow-up of 24 months post-challenge.
• Analysis of patient progression, reactions, and associated factors.

Main Results:

• Of 206 patients challenged, 99 passed. Of 187 sent home with BM, 43% progressed to direct milk, 20% to less-cooked forms.
• Higher milk IgE levels correlated with lower BM challenge success and progression.
• 33% of patients reported reactions, 14% severe; 6 developed eosinophilic esophagitis.

Conclusions:

• Most patients, including those failing challenges, can progress to other milk forms after BM introduction.
• Adverse reactions are frequent, and successful BM challenges do not guarantee sustained tolerance or prevent future reactions.