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Baked milk and egg diets revisited
Julia E M Upton1, Dennis Wong2, Anna Nowak-Wegrzyn3
1SickKids Food Allergy and Anaphylaxis Programme, Division of Immunology and Allergy, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada; Division of Clinical Immunology and Allergy, Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Division of Clinical Immunology and Allergy, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Baked milk and baked egg diets help children overcome milk and egg allergies. These modified proteins in baked goods can be safely introduced, even at home, aiding oral immunotherapy and allergy resolution.
Area of Science:
- Food Allergy Research
- Clinical Immunology
- Pediatric Allergy Management
Background:
- Most children with milk and egg allergies tolerate modified proteins in baked goods due to denaturation.
- Baked milk (BM) and baked egg (BE) diets are increasingly used in managing these allergies.
- Current diagnostic tests struggle to predict tolerance to BM/BE products.
Purpose of the Study:
- To review the role of baked milk and baked egg diets in managing IgE-mediated and non-IgE-mediated allergies.
- To discuss different introduction approaches, including supervised challenges and home-based 'ladder' protocols.
- To highlight the potential of BM/BE diets in hastening allergy resolution and prevention.
Main Methods:
- Review of current literature and clinical practices regarding BM/BE diets.
- Discussion of oral food challenges and home-based graded ingestion protocols ('ladder').
- Reference to a randomized controlled trial demonstrating efficacy in milk allergy resolution.
Main Results:
- BM/BE diets are effective in managing milk and egg allergies, particularly IgE-mediated forms.
- Home-based 'ladder' protocols, a form of oral immunotherapy, can be used for safe introduction.
- Baked diets can hasten the resolution of IgE-mediated milk allergy.
Conclusions:
- BM/BE diets are valuable tools in pediatric allergy management, offering a pathway to tolerance.
- Home introduction protocols require careful risk assessment and patient education.
- BM/BE foods show promise in both treating and potentially preventing IgE-mediated allergies.
