Background: Milk and egg are common food allergens in children. The majority of milk and egg allergies in children are known to be of a milder and transient phenotype, where children can often tolerate baked forms of these allergens. Hence, many children with milk and/or egg allergy and with the milder phenotype are introduced, maintained, and progressed on the baked forms of the allergens by using a variety of interventions, with the goal of accelerating the development of tolerance to milk and/or egg. Methods: We reviewed recent evidence with regard to four types of interventions with baked milk and/or egg, including baked milk and/or egg diets, ladders, dietary advancement therapy, and oral immunotherapy (OIT). Results: Based on the literature, for children who are baked milk and/or egg tolerant, both baked milk and egg diets as well as ladders may be appropriate. For children who are baked milk and/or egg reactive at age of = 3 years, baked milk and/ or egg oral immunotherapy may be a more appropriate route. Other factors that may help determine whether a child is a good candidate for these interventions include medical history (asthma, anaphylaxis, respiratory and/or cardiovascular comorbidities), results of allergy testing, caretaker level of comfort, and previous adherence to medications. Conclusion: To better implement these interventions, it is important for rigorous studies to be conducted to allow for the development of universal guidelines for screening and to standardize dosing.
Dupuis et al. (Sun,) studied this question.