Cow’s milk and hen’s eggs allergies are among the most common in children. Increasing evidence is supporting that many of these children can tolerate baked milk or egg, such as in a cake or cookies. Studies have shown that 70% of children with egg allergy can tolerate cooked egg. 75% of children with cow’s milk allergy can tolerate baked milk. Incorporating these foods into the diet is well tolerated. Being able to add baked milk or eggs into the diet can increase quality of life by expanding the diet, helping nutrition and promoting inclusion to childhood activities. There is debate how these foods should be incorporated to the diet, whether its at home or in a supervised setting such as a doctors office. There have been some episodes of anaphylaxis reported.
Specific parameters such as serum specific IgE levels and skin prick testing are being currently studied. Component testing is a relatively new test that can elucidate these questions. For eggs, the ovalbumin and ovomucoid proteins are tested. If the ovomucoid is positive a child is at high risk of reacting to all forms of egg including baked egg. If only the ovalbumin is positive, there is a low risk of reaction to cooked egg and the patient is likely to outgrow egg allergy.
For milk component testing, alpha lactalbumin, Beta lactoglobulin and casein are tested. If Casein is positive, the child should avoid all forms of cow’s milk and he/she will unlikely become tolerant over time. If the alpha or Beta lactoglobulin are positive and the casein is negative, he/she should avoid fresh milk, but are likely to tolerate baked milk products. Baked milk and oral food challenge with an allergist may be appropriate. They are likely to outgrow the milk allergy.
In conclusion, if a child is diagnosed with milk and egg allergy, there is a strong chance he/she can tolerate baked milk or eggs. One should speak to their allergy doctor to see if an oral food challenge is warranted.
The component testing for milk and egg allergy helps determine the likelihood of reaction to products baked with egg and milk. If the egg component testing is positive to ovomucoid and the milk component testing is positive to casein, baked products with those ingredients should be avoided and there is less likely chance of “outgrowing” the allergy.