Baked Milk Challenge

I took my allergy boy to the allergist recently. He’s six and a half and he’s allergic to dairy, eggs, bananas and tree nuts. The appointment was for an oral allergy challenge to baked milk.

My allergy boy was about 5 months old when we discovered his food allergies. We were at a restaurant and he was playing with a spoon that I’d used to stir my coffee with milk. He started fussing and when I looked at him one side of his face was red, swollen and covered in small hives. I wasn’t exactly sure what was on the spoon; coffee and milk for sure, possibly eggs too. So when we went to the allergist a few months later she tested him for dairy, eggs, peanuts and tree nuts. I wish I’d thought to take pictures at the time because the welts from the skin tests were huge. Dairy and eggs were the culprit. He tested negative for peanuts and tree nuts that day.

My allergy boy had his first anaphylactic reaction the first time he ate bananas when he was about 18 months old. He was about two and a half when he had his first reaction to tree nuts (in a weird coincidence, on the way to the allergist).

It honestly wasn’t that hard adjusting. When his allergies to dairy and egg were first confirmed, he was still almost exclusively breastfed. As we introduced him to foods, and as he started eating what we were eating, we modified the way we prepared food. I learned – a lot of the time through trial and error – what worked and what didn’t, and what my allergy boy liked and what he didn’t. I stopped wasting my money on alternative cheeses and “dairy” products a long time ago. If it looked or sounded anything like real cheese or other dairy product, he wouldn’t go near it. There is a multitude of cookbooks and websites out there dedicated to vegan cooking and baking, and allergy friendly cooking and baking. We’ve always managed fairly well.

Having a kid with lots of food allergies changes the way you think about food. I was moved by The Allergist Mom‘s post My Disordered Eating, in which she talks about food and emotions, and how she feels about eating foods her kids are allergic to. I wrote about how dairy gets on my nerves here.

But now, after today’s challenge, we’ve been told to give our allergy boy milk – only small amounts and only when it’s been baked into bread, or muffins or something like that – and I don’t know how I feel about it.

You see, we’re okay. Our diets are fine. I can cook or bake just about anything that everyone else can and make it safe for my allergy boy (with the exception of maybe lasagna and quiche). We’ve done pretty well, thank-you-very-much.

I’d love for my allergy boy to grow out of his allergies because (a) he’d be safe from the ever-looming allergic reaction and (b) he’d never be excluded from anything again based on food. But I have no great desire to consume dairy and eggs like we did before. I put coffee in my milk and we often have grated cheese at the dinner table for those who can eat it or who want to sprinkle it on whatever dish we’re having. So the rest of the family hasn’t eliminated it completely, but we certainly eat less than the average household. We really don’t feel like we’re missing out on things. The idea of starting to bring dairy and eggs back into baking is … I don’t know … unsettling somehow.

However, there is a good reason to start baking with dairy and eggs again. I’ll try to share my very basic understanding of food allergies and how this supposedly works: For some reason which nobody seems to understand, the body of an allergic person recognizes certain parts of food (usually a protein) as a threat. As a result, the immune system kicks in, and (among other things) releases histamine. I’ve heard an allergic reaction described as “an overreaction of the immune system”. Histamine is mainly responsible for all the things you might see in an allergic reaction: hives, rashes, wheezing, sneezing, runny nose, gastrointestinal symptoms, drop in blood pressure, swelling, etc.

[For a really good description of food allergies and anaphylaxis, read these two amazing posts: The Science of Anaphylaxis – An Allergic Storm and The Science of Sensitization (or How in the World We Become Allergic…)]

Certain allergens change when they are heated, and for some allergic people, they change enough so that the body no longer recognizes them as a threat. Allergists have known for a long time that one of the proteins in eggs changes significantly when cooked and that it is common for egg allergic people to be able to eat baked goods with small amounts of egg in them (one or two eggs in a cake, for example).

A few years ago we were told to try to introduce our allergy boy to eggs baked into something. I tried eggs baked into cookies and wrote about it here. We’ve tried baked eggs on and off over the last few years. When he doesn’t know it’s there he seems to tolerate it okay. Sometimes he’d have a bit of eczema a couple of days later, or sometimes he’d have the slightest bit of tummy upset but he usually tolerated it well enough. But when he knew it was there, he didn’t want it. Eventually Mr. FamilyNature and I thought “why are we doing this?” It was kind of stressful, my poor allergy boy hated it, and I felt guilty every time he had even the slightest hint of a reaction. So we stopped.

We were at the allergist in May for my allergy boy’s annual allergy tests. The allergist did skin tests for milk, egg and banana. E = egg, RE = real [fresh] egg, M = milk, RM = real [fresh] milk, B = bananas.

The welts look impressive but as these things go, the hives were relatively small. The allergist ordered RAST blood tests we discussed the possibility of a baked milk challenge.

There is fairly new research that indicates that the proteins in milk change when they are heated, just like egg. More than that, the new research suggests that for those who can tolerate milk in baked goods, that eating milk in baked goods can actually help a person outgrow a dairy allergy.

The idea of exposing an allergic person to their allergen to help them build up a tolerance is not new. This is the theory behind allergen immunotherapy (aka allergy shots) and they’ve been around for ages. My dad remembers getting allergy shots as a kid (that would have been late 50’s, early 60’s).

I’m really not sure why allergen immunotherapy hasn’t been more popular with food allergies. I’m going to guess that it’s because food allergies are more likely to cause anaphylaxis (as opposed to environmental allergies, which is what my dad had allergy shots for). I’m also guessing that researching allergen immunotherapy with food allergies – in which inducing anaphylaxis in kids is a possible outcome – is complicated, to say the least. There are studies out there but currently it’s not a therapy that is commonly used for food allergies.

The new research regarding baked milk seems promising, and more importantly, our allergist believes it’s safe. And if it can help my allergy boy grow out of his dairy allergy, then despite my feelings about it, I have to give it a try.

3 thoughts on “Baked Milk Challenge

  1. Patience

    I feel that way about peanuts. We started having them (ie peanut butter) in the house again but younger dd doesn’t really care one way or another and after having a few sandwiches; it was like whatever.
    We do have a lot of dairy and eggs but minimal or no grains. I miss being able to put together a pasta dinner or just send out for random pizza. (I make a gf pizza once a week) So now I don’t eat bread really as I can’t be bothered but occasionally bake bran muffins for myself or cake for the kids.
    Dh did immunotherapy (I’m thinking you mean like allergy shots??) and he could never remember leaving the allergists office as they put him in a buzz so forget that. Dh has way more allergies than older dd. (however I wish we could find a cure for his incense allergy as they use it more and more at church… 🙁 )

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