Home-based Cow’s Milk Reintroduction Using a Milk Ladder in Children <3 Years Old With IgE-Mediated Cow’s Milk Allergy

Abstract

HB Ball, D Luyt. Clin Exp Allergy . 2019;49(6):911–920 Although the majority of children with IgE-mediated cow’s milk allergy outgrow their allergy, it has been shown that tolerance to extensively heated milk (baked milk) often develops earlier than to fresh milk, and early regular dietary incorporation of baked milk is associated with accelerated resolution of milk allergy. Since 2012, the authors have managed selected young children with IgE-mediated cow milk allergy with a home-based milk reintroduction (HMR) followed by at-home exposure to increasing amounts of cow’s milk with a locally devised milk ladder. Children younger than 3 years of age with diagnosis of IgE-mediated cow milk allergy (presenting with skin and/or gastrointestinal symptoms only and skin prick test <8 mm) were considered for home-based milk reintroduction (HMR). Children considered unsuitable for HMR included history of …