Talking Allergies

Baked Milk challenge today.....
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Author:  Momtobunches [ Wed Oct 27, 2010 10:55 am ]
Post subject:  Baked Milk challenge today.....

The appointment is finally here. I have baked a chocolate cake with 2/3 cup of milk in it, at 350 degrees for more than 30 minutes. Don't have the issue handy, but I think that's what the article in the magazine said? The office couldn't give me much guidance, they just said the amount of milk wasn't as important as the temp it was cooked at, and length of time.

My son is terrified, but I am optimistic! Last year I KNEW that he was going to fail the nut challenge, but this one has so much more riding on it - if we can start to allow cooked milk into his diet, I can happily live with his nut allergy!

Just a little nervous because when he has reacted to cooked milk in the past, it took almost an hour for the reaction to develop. And then it was a doozy.

Will post results later....

Author:  alberta advocate [ Wed Oct 27, 2010 11:01 am ]
Post subject:  Re: Baked Milk challenge today.....

:huggy :thumbsup


Author:  _Susan_ [ Wed Oct 27, 2010 11:29 am ]
Post subject:  Re: Baked Milk challenge today.....

I don't blame him for feeling nervous but, you are aware of the risk (small-the Dr's suspect he will pass), will be vigilant, have a plan and are prepared to implement it if need be.

Brave boy! :thumbsup We're rooting for you! :popcorn

Author:  BC2007 [ Wed Oct 27, 2010 11:35 am ]
Post subject:  Re: Baked Milk challenge today.....

:huggy I'll be thinking about you, fingers and toes are crossed.

Author:  katec [ Wed Oct 27, 2010 9:32 pm ]
Post subject:  Re: Baked Milk challenge today.....

Good luck. Are you referring to the article in Allergic Living? If he passes where do you go from here?

Author:  Momtobunches [ Wed Oct 27, 2010 10:17 pm ]
Post subject:  Re: Baked Milk challenge today.....

Yes, I'm referring to the article in AL's summer issue I think? It talked about how so many kids are tolerating baked milk.

So we're done.... very interesting day. I want to write a more detailed summary of what happened, because as our allergist pointed out, this kind if thing is in its infancy. He actually told me at the end of the appt to seek out others online who have kids in the same boat, so I'd like to see a new thread started for sharing baked challenge stories. They do them almost every day at the office, and the nurse said it seems like 98% of the kids get all the way to the end! Very exciting stuff!

I'll write more details later...

Author:  Momtobunches [ Wed Oct 27, 2010 11:27 pm ]
Post subject:  Re: Baked Milk challenge today.....

OK, kids are in bed now..

They started by taking his vital signs. Then they did skin tests for 5 things : histamine, control, cow's milk serum (the clear liquid), real cow's milk, and a bit of smushed up cake mixed with water to make it mushy. Considering that I only used 2/3 cup of milk for an entire cake, and this was maybe a pinky nail sized amount of cake, there was maybe a drop of milk in there, if any.

Predictably, the histamine, cow's milk serum and cow's milk all flared - but so did the cake! The real milk was the largest - at least an 8, and he was VERY uncomfortable. I thought the test would be over right there, but the proceeded to wipe some of the cake mixture on his cheek. Nothing happened, but then again, I didn't see any "brown stuff" on his cheek - so not sure they actually managed to get any cake to stay there.

Next was outer upper lip. She asked him not to "lick", so he started to complain of tingling, and it did look a little swollen, but not compared to last year's walnut challenge (this is where it ended for him last year). Still nothing obvious except for some itchiness, so they went to inner lip - tucked it between his lip and his gums on the lower lip. He was trying hard not to swallow any, and keep it "parked" there, so he was uncomfortable again - he now says that maybe he wasn't really itchy, maybe it was just that there was so much saliva building up in there that he couldn't swallow.

Next was tongue - he was pretty good with this one, and did end up swallowing almost all of it by the time the 15 minutes was up. For each of these tests, they put only a tiny amount - what looks like a few crumbles of cake.

Now comes the actually eating. 1st bite was maybe 1/2 a teaspoon of cake. He said it was GOOD!!! He was so afraid that real milk would make it taste bad - he's feeling pretty good now! 15 minutes later, no rash, no vomiting ... so another bit, this time about 1 tsp. 15 minutes later - ready for the 3rd bite. They gave him about 1 tbsp full this time. So still a really small amount.

I realize that this means he has completed all the stages, but I'm still nervous because a few episodes of anaphylaxis happened a good 1/2 hour - 45 minutes after he ate the food, so I knew we were still in the "risk" time frame. A few minutes after the 3rd bite he complains of a little heartburn - pain in the mid-chest area. His vitals are perfect, and he is showing no physical signs of a reaction. He sneezed once, but it was probably unrelated.

That was it! They said he passed! I'm confused at this point, because it total, he maybe had 1 fork-full of cake over a period of 2 hours, that didn't seem to be huge progress to me.

The allergist then met with us, and told us that since he didn't react, we could now allow him to eat food that has milk in it that has been exposed to high temperature cooking. I asked some specifics ... scrambled eggs? No, not scrambled eggs. Not hot enough, or long enough. What about pizza? Cheese? He said that possibly he could have cheese - but only very highly processed cheese (sadly). Absolutely no raw milk or cold milk products - we're still dealing with a very severe milk allergy, after all, and he is still testing very positive.

He said that they still don't really know the specifics of how to handle this, that my best option would be to seek out others online who had kids with a similar allergy, and find out what foods they were tolerating.

So we're going to go one day at a time. I may offer him small pieces of the cake each day for the next several weeks, and go from there. Maybe some bread - it's baked a long time - but otherwise, I'm not sure. I'm not expecting my son, who's 10, to start wanting to eat a whole bunch of new food, even though this opens up a whole new world for us!! Maybe we don't have to turn down restaurant chicken nuggets anymore?? AHHH! :scratchy Part of me wants to dive in and trust the results from today, and part of me wants to deny it ever happened! I'm still afraid he might react to something, and I don't want to put him through that or it could set us back even further.

So I'm going to start a thread in the milk / egg forum for us to share what foods our kids have been able to tolerate, as milk and egg are so very similar in this situation!

One last interesting point ... he mentioned that my son's heartburn today may have been cause by a lactose intolerance. Huh?? He said that while it's not likely he has an actual lactose intolerance (which is actually pretty rare), for a person who has never really been exposed to lactose on a regular basis, the body is not equipped with enzymes at the ready ... so people who suddenly start to take milk may actually show symptoms of GI intolerance for a while. Simple solution - use lactose-free milk for the baking challenges until he's more used to it.

This makes sense to me ... so many people out there "think" they have a milk allergy, and talk about how after a few months off of it, they feel ill when they go back on it, thus confirming the allergy - even though they test negative, and doctors tell them they're not allergic. Hmmmmm......

Author:  BC2007 [ Thu Oct 28, 2010 7:13 am ]
Post subject:  Re: Baked Milk challenge today.....

That is wonderful, every baby step is a HUGE step when it comes to allergies. Momtobunches make sure to take some time for yourself to unwind, I'm sure the process was equally anxious for you as it was for your DS.

I'm curious now, does this mean that although there are specifications on what type of milk product he can ingest if an accidental exposure should happen the reaction, if any would be minimal (say to trace from pizza)?

Hugs from one allergy mom to another. :huggy

Author:  katec [ Thu Oct 28, 2010 8:56 pm ]
Post subject:  Re: Baked Milk challenge today.....

This is wonderful news for you. I am surprised that the test was considered passed after your son only ate a small sample of the cake. Do you have to gradually increase the quantity of foods made with milk over time? I want to talk to our allergist about taking this sort of challenge. We would likely do an egg challenge first since her egg numbers are lower than her milk scores.

Did your allergist suggest to you that eating baked goods with milk might eventually over time lead to outgrowing the allergy completely? I think the article in AL mentioned that there was hope that tolerance for milk would increase as patients ate baked goods.

Let us know about your son's progress. This is so exciting.

Author:  Momtobunches [ Fri Oct 29, 2010 10:52 am ]
Post subject:  Re: Baked Milk challenge today.....

Thanks katec! I was surpised too. But yesterday after school I have him a bigger piece - about 1/4 cup of the cake, and he had no problems :banana !! This is so huge. They are having such success with milk and egg - the nurse said 98% of the kids they challenge get all the way to the end, so their selection criteria must be very good. Strangly, my son's RAST numbers are still huge, but because it was such a big drop (from >100 to 58 ... normal is around 1 or 2) they thought it meant he might be ready.

While we still need to be extremely vigilant around "fresh" milk products - basically everything cold - this means we can relax around baked goods. Of course, he's still allergic to nuts, so I'm not really sure how much this opens things up.

We asked him about the need to give it every day in order to "maintain" his new status, and to possibly help him grow out of it completely (like the article said), but he said they really don't have any idea at this point. So we don't have to feed it every day, we just can start trying to include him in on hot meals that may or may not have milk in it. I think I will still feed him a small piece of the cake each day until it's gone, then try breads / buns etc from that point on.

I hope many others get to this stage soon so we can share food ideas!

Author:  Jesko [ Mon Nov 01, 2010 5:54 pm ]
Post subject:  Re: Baked Milk challenge today.....

Hi! I am new to the forum, we have recently completed the Baked Egg challenge in September, and the Baked Milk challenge in October with success!
I am glad to have someone to talk to about the test and the "Well, that's cool now what?" question.
My son is allergic to Egg (do we now say uncooked egg?), Milk (uncooked milk) and Peanuts, and Penicillan, experiences hot/cold urticaria and has asthma.

His RAST test shows his egg and milk in the 6-7 range which is WAY lower than in the past, peanut up a bit (used to be very low) to a 17. No more 30's though!

So, the test was actually in my opinion very rougue - we had no vital sign checks etc just well, did you bring the egg baked in (actually baked it in wrong, luckily still fine with proper amount), feed him a taste, wait 30min, feed him a 10th, then a 1/3d and a 1/3d waiting 1/2 hour between, in the end consuming a whole cupcake.

No reaction - great - keep feeding it to him at home. See you in a month for the milk.

Milk test, I asked them to check his Asthma first - so a spiro test - was great - ok- out to the Hospital waiting room, same procedure as the egg - luckily same results.

So, here we are, he can now have some home baked items with egg and milk - keeping to the 30 minutes at 350 degrees, also, the allergist mentioned having a wheat base in anything we give with milk - not entirely sure of the connection.

Tonight, we are trying a new chicken strip with a "may contain milk, egg and soy" - fairlly confident however, biggest challenge is convincing the allergic child that suddenly, these forbidden foods are now ok and to trust in the test (even when I am a little unsure, but we'll get there in time)

So, if anyone has any input on what to do now, how much leeway can you give to the school (my instinct was to keep it to ourselves as I don't want to undo all of the work we have done, especially for the other children who may come in to the school)
So, I can say we are a little confused (extremely happy) but confused all at the same time.

Thanks for reading

Author:  Momtobunches [ Mon Nov 01, 2010 6:29 pm ]
Post subject:  Re: Baked Milk challenge today.....

Wow, thanks for sharing your story! I agree about the school - I'm keeping it quiet. It doesn't change much anyway, considering that most of the problem foods at school are cheese and yogurt ... which they are still allergic to.

Interesting about the wheat base ... I'm guessing that he meant that it truly had to be something "baked" rather than cooked. I'm thinking of a casserole with melted cheese on top - even if it meets the temp / time requirment, would it be "altered" enough from it's raw form? I think there must be some kind of a reaction between the milk and the flour so that the molecular structure of the milk protein actually changes enough for their bodies to accept it.

On that note, I don't think I'm going to ever give him anything with cheese at this time, baked or not (although the allergist said that highly processed cheese - like Kraft slices would probably be OK). We'll stick with breads and cakes and maybe muffins.

As for the "may contain" - we've always given chicken nuggets with "may contain" warnings on them, and he never reacted .... so you should be OK there. I'm trying to decide if I want to try those that actually have milk in their ingredients. I'm thinking if it says "milk ingredients" then maybe, but if it's romano or parmesan cheese, then no.

Author:  katec [ Mon Nov 01, 2010 8:18 pm ]
Post subject:  Re: Baked Milk challenge today.....

Great to hear more positive news about baked challenges. How old are your children? Is age a consideration when attempting this challenge? I want to raise this issue at our next allergy appointment. I assume that allergists must be communicating their findings with each other somehow about these kinds of challenges. My daughter's egg rast (3) is low and her milk was lower last time as well (13).

Author:  Amy's Mom [ Mon Nov 01, 2010 8:24 pm ]
Post subject:  Re: Baked Milk challenge today.....

This is super exciting. :banana We are booked for this challenge in May. Fingers crossed.

Author:  Momtobunches [ Mon Nov 01, 2010 9:16 pm ]
Post subject:  Re: Baked Milk challenge today.....

I don't think there's any age requirment - our's was based on the fact that his RAST dropped from >100 to 58. Still very high, but a significant drop. His total IgE also dropped huge. There wasn't any one piece of evidence, it was the whole picture that the allergist liked.

Definitely bring it up at the appointment! Sounds like this is developing right before our eyes! Our 1st allergist (Dr. Van der Leek) moved away, and said that there was only 1 allergist he knew of at the time that was doing food challenges in Calgary at all. That was 2002. BIG progress!

Oh, and BTW - my son is 10. His RAST was always >100 each year from the time he was 2 1/2.

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