Oral food challenges to baked milk and egg: Benefits and risks

Background: The majority of children with milk and egg allergy can tolerate these allergens when extensively heated. Aside from oral food challenge, there are no other current diagnostic tools to accurately predict tolerance of baked milk or egg. Objective: The objective was to identify optimal candidates for baked oral food challenges and participate in shared decision-making with families with regard to timing and location of introduction. Methods: The methods include a review of the current literature with regard to diagnosis, prognosis, diagnostic testing, and oral food challenge outcomes for children with milk and egg allergy. Results: Without available skin or blood tests to best assess tolerance of baked milk and / or egg, clinicians need to have an understanding of the benefits and risks associated with oral food challenges. Conclusion: Shared decision-making that surrounds baked challenges should occur at the time of initial milk and egg allergy diagnosis and include discussion of benefits and risks.