‘Milk ladder’ approach to treating children with allergies backed by Irish researchers

Food allergies occur when the immune system reacts abnormally to otherwise harmless food proteins, which can cause immediate symptoms such as vomiting, diarrhoea, hives and respiratory issues.

Severe reactions can lead to anaphylaxis, a life-threatening condition requiring emergency medical attention.

Researchers at the Irish Centre for Maternal and Child Health Research at University College Cork (UCC) and Cork University Hospital (CUH) have shown cow's milk can be safely and eff­ectively reintroduced to children with milk allergies.

Traditionally, cow's milk allergies are managed through strict avoidance of milk in all forms, followed by a series of outpatient appointments and allergy tests, often culminating in a hospital-based milk reintroduction.

This process can be lengthy and stressful for both the patient and their family, requiring extensive time and medical resources.

However, researchers at UCC have demonstrated that using the "milk ladder" method as a step-by-step approach allows for a home-based reintroduction of milk under the careful supervision of caregivers.

"This method significantly reduces the need for hospital visits and en­ables the immune system to gradually become less reactive to milk proteins," they said in the study, which was published in the Journal of Paediatric Allergy and Immunology.

"Most notably, the children managed with the milk ladder were almost four times more likely to successfully reintroduce milk compared to those who followed the traditional avoidance approach."

People should not use the milk ladder on their children without getting the advice and recommendation of a specialist allergy team.

The process involves several steps, starting with baked milk, where the cow's milk protein has been extensively heated and mixed with a carbohydrate such as a biscuit for about 20 to 30 minutes in an oven.

This alters the cow's milk protein and it is therefore less likely to cause an allergic reaction.

The ladder then progresses through several stages to cooked milk and lastly to uncooked milk.

In Ireland, the three most common food allergies in children aged under three are eggs, cow's milk and peanuts.