Background
A significant proportion of cow’s milk allergic (CMA) children, can tolerate extensively heated and baked milk (EHBM). Consumption of EHBM may promote allergy resolution, however, no consensus exists as to the required amounts and treatment protocols. We retrospectively evaluated a structured gradual exposure protocol (SGEP) including EHBM for the treatment of children with CMA.
Methods
In a case control study, CMA children aged 1-4 years who were treated with SGEP including EHBM, were compared to children treated with strict avoidance. Data was collected from medical records and from validated telephone questionnaires. Data analysis was performed using non-parametric Kaplan-Meier and proportional hazard Cox regression model, after evaluation of the adequacy of the case control matching.
Results
43 milk allergic children, 26(62%) males, mean age at intervention 21 months (12-47), were treated with SGEP and followed to a mean age of 40 months (20-82). The median age at resolution of CMA was compared to a matched group of 67 children treated with strict avoidance at least until 4 years of age or followed until earlier resolution, mean age at follow up 71 months (11-176). The median estimated age at CMA resolution in the SGEP group was 36 months (95% CI 36.5-49.7), compared to 98 months (95% CI 82.4-114.1) in controls, p
Conclusion
A structured protocol with EHBM appears to promote faster resolution of CMA
