LONG TERM TOLERANCE OF MILK IN ALLERGIC PATIENTS UNDERGOING BAKED MILK FOOD CHALLENGES

Abstract

Introduction Many cow's milk allergic children can tolerate extensively heated forms milk. Tolerating baked milk products can even accelerate tolerance to less heated milk. The aims of this study are to follow-up patients who tolerated baked milk oral food challenges (BMC) and characterize their tolerance of less heated forms of milk. Methods We performed retrospective chart reviews of milk allergic patients who visited our pediatric allergy clinic from January 2008 to December 2017 and passed BMCs to muffin. We characterized their progression to lesser (un)heated milk products. Results Preliminary data demonstrates approximately 77 % of milk-allergic patients continued to tolerate baked products for at least 1 year after their BMC. 44% of subjects who passed a BMC and introduced baked milk at home ultimately tolerated unheated milk within the time frame of the study. Baked milk tolerant patients required a median of 36 months (IQR 38.5-37) to progress towards tolerance of unheated milk. Consumption of baked products after the BMC was not associated with severe symptoms including respiratory distress or anaphylaxis. Mild symptoms noted with ingestion of baked milk included oral itching, localized hives, and/or abdominal pain. Conclusions Overall, preliminary results confirm consuming baked products at home after challenges is safe, with minimal risk of severe reaction. Tolerance to lesser/ unheated milk is likely to be achieved if baked products are regularly kept in the diet.