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The effect of baked milk on accelerating unheated cow's milk tolerance: A control randomized clinical trial
Author(s) -
Esmaeilzadeh Hossein,
Alyasin Soheila,
Haghighat Mahmoud,
Nabavizadeh Hesamodin,
Esmaeilzadeh Elmira,
Mosavat Fereshteh
Publication year - 2018
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12958
Subject(s) - medicine , milk allergy , oral food challenge , casein , randomized controlled trial , cow's milk allergy , beta lactoglobulin , milk protein , allergy , food allergy , food science , whey protein , immunology , chemistry
Background Assessing the effect of adding baked milk products to the diet of patients with cow's milk allergy on accelerating the formation of tolerance. Method A randomized clinical trial was carried out with 84 patients (6 months‐3 years old) diagnosed with allergy to cow's milk who tolerated baked milk in form of muffin in oral food challenge ( OFC ). The subjects were divided randomly into case and control groups matched for age and sex. Patients in the case group were asked to consume baked milk in the form of muffin for 6 months and then to consume baked cheese in the form of pizza for another 6 months. The control group were instructed to strictly avoid any milk products for 1 year. Skin prick test ( SPT ) and serum‐specific immunoglobulin E ( sIgE ) levels (Immuno CAP ) of milk, casein, and beta‐lactoglobulin were measured before and after the study. In addition, those in the case group who had satisfactorily tolerated baked products during the study as well as all the subjects in the control group underwent an OFC to evaluate unheated milk tolerance at the end of the study. Results It was shown that by the end of the 1‐year study period, 88.1% (37/42) of the patients in the case group and 66.7% (28/42) of those in control group had developed tolerance to unheated milk ( P ‐value: 0.018). The results of milk‐specific SPT and sIgE levels showed a significant decrease in the case group. Initial sIgE levels could not predict unheated milk tolerance in case and control groups. Conclusion Introducing baked milk products into the diet of patients with milk allergy can accelerate the tolerance of unheated milk in these patients. sIgE levels of milk, casein, and beta‐lactoglobulin did not predict the tolerance of unheated milk.