Use of baked milk challenges and milk ladders in clinical practice: a worldwide survey of healthcare professionals

Athanasopoulou, Panagiota; Deligianni, Elena; Dean, Taraneh; Dewey, Ann; Venter, Carina

doi:10.1111/cea.12890

Cited by 29 publications

(47 citation statements)

References 14 publications

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“…Sesame allergy is frequently encountered in the Middle East and Israel, but sesame allergy is infrequently encountered outside of these countries and Europe. 40 Although many clinicians make the decision about OFC location on clinical experience, 55 introduction of BM or BHE at home may pose a risk, particularly with IgE-mediated allergy and some forms of non-IgE-mediated food allergy such as severe food protein-induced enterocolitis syndrome (FPIES). 63,67 In the USA, a recent death associated with a physician-supervised baked milk challenge in a child with IgE-mediated cow's milk allergy highlights the risk.…”

Section: Sesame and Other Seedsmentioning

confidence: 99%

“…The BSACI guideline for the diagnosis and management of cow's milk allergy (CMA) suggests gradual home introduction of BM in children who have had only mild symptoms on "noteworthy exposure" to milk (such as a mouthful) and no reaction in the past 6 months and (for those with IgE-mediated CMA) a significant reduction in sIgE/ SPT 54. Although many clinicians make the decision about OFC location on clinical experience,55 introduction of BM or BHE at home may pose a risk, particularly with IgE-mediated allergy and some forms of non-IgE-mediated food allergy such as severe food protein-induced enterocolitis syndrome (FPIES) 63,67. There is considerable debate around the aforementioned, as Nowak-Wegrzyn et al64 found that of the children who were reactive to BM on challenge, 35% experienced symptoms of anaphylaxis and 4% of those challenged to BHE received epinephrine 65.…”

mentioning

confidence: 99%

“…There is considerable debate around the aforementioned, as Nowak-Wegrzyn et al64 found that of the children who were reactive to BM on challenge, 35% experienced symptoms of anaphylaxis and 4% of those challenged to BHE received epinephrine 65. Box 3 proreflux and constipation) although no prospective studies have been performed to assess efficacy of these ladders 55. The Mount Sinai cohort indicated that those with lower serum egg white, ovomucoid and ovalbumin-specific IgE levels and lower ovomucoid and ovalbumin IgE/IgG4 ratios were more likely to tolerate baked egg 58,65.…”

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confidence: 99%

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A patient‐specific approach to develop an exclusion diet to manage food allergy in infants and children

Venter

Groetch

Netting

et al. 2018

Clin Experimental Allergy

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Food allergy is becoming increasingly common in infants and young children. This article set out to explain the different factors that should be taken into account during an individualized allergy consultation: Foods to avoid and degree of avoidance, suitable alternatives, self-management skills, co- and cross-reactive allergens and novel allergens alongside the role of the industry in allergen avoidance, importance of nutritional aspects of the diet and the future directions that nutritional guidance make take. Allergy management advice should be individualized to provide a patient-specific approach. Changes in the management of food allergies have in particular occurred in nut, milk and egg allergies over the past few years. There has also been a progressive increase in our understanding of cross-reactivity between different foods and also food and aero-allergens. A patient-specific approach of allergen avoidance should consider factors relating to industry and the environment such as food and nutrition literacy, threshold levels, cross-contact/contamination and safe eating away from home. Increasing migration and travel has also led to exposure of unfamiliar foods. As understanding improves on individual allergens and threshold levels, food labels and food labelling laws are affected. Allergy specialist dietitians should also keep up to date with the latest information on nutrition, the gut microbiome and the immune system to incorporate nutrition strategies in a dietetic consultation using an evidence-based approach.

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Section: Sesame and Other Seedsmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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A patient‐specific approach to develop an exclusion diet to manage food allergy in infants and children

Venter

Groetch

Netting

et al. 2018

Clin Experimental Allergy

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“…40 Unfortunately, there seems to be limit evidence to suggest that this approach speeds up outgrowth although it may simplify meals times for families. A popular approach is to initiate patients with cow's milk or egg allergy on baked milk or baked egg, respectively.…”

Section: Food Allergymentioning

confidence: 99%

“…A popular approach is to initiate patients with cow's milk or egg allergy on baked milk or baked egg, respectively. 40 Unfortunately, there seems to be limit evidence to suggest that this approach speeds up outgrowth although it may simplify meals times for families. 41 A potential treatment strategy is omalizumab, and Vetander and colleagues publish data to suggest that an individualized dosing can prevent reactions in patients with food allergy.…”

Section: Food Allergymentioning

confidence: 99%