Milk ladder: Who? When? How? Where? with the lowest risk of reaction
The milk ladder (ML) approach, which is the gradual reintroduction of the milk allergen from the least allergenic forms to the most allergenic forms into the diet of the patients, has been utilized mostly in non-IgE-mediated but in some countries also in IgE-mediated-CMPA due to its possible benefit...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-12-01
|
| Series: | Frontiers in Allergy |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/falgy.2024.1516774/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850053455314419712 |
|---|---|
| author | Betul Buyuktiryaki Ozge Soyer Duygu Yazici Duygu Yazici Gulbin Bingol Ceren Can Hikmet Tekin Nacaroglu Aysen Bingol Ebru Arik Yilmaz Metin Aydogan Cansin Sackesen |
| author_facet | Betul Buyuktiryaki Ozge Soyer Duygu Yazici Duygu Yazici Gulbin Bingol Ceren Can Hikmet Tekin Nacaroglu Aysen Bingol Ebru Arik Yilmaz Metin Aydogan Cansin Sackesen |
| author_sort | Betul Buyuktiryaki |
| collection | DOAJ |
| description | The milk ladder (ML) approach, which is the gradual reintroduction of the milk allergen from the least allergenic forms to the most allergenic forms into the diet of the patients, has been utilized mostly in non-IgE-mediated but in some countries also in IgE-mediated-CMPA due to its possible benefits which include nutrition, quality of life and tolerance induction. Despite increasing interest, so far, there is no guideline on ML; thus, the use of this approach shows discrepancies among healthcare professionals as many factors such as dietary habits, patient history, test results, workload, and facilities of the hospitals, the anxiety of the parents/patients may affect the decision on how, when, where and whom to use ML. Here, we reviewed current data on implementing the ML, suggested a 4-step ML including receipts and amounts, and shared our experience on optimal patient selection, appropriate time and steps for initiating ML, and time intervals between the steps targeting the lowest risk of reaction. We also added the newly developed twice-baked biscotti cake to the ML. We presented the analyses of this product, showing its low allergenicity compared to conventional cake, which provides a safer introduction of milk into the diet. |
| format | Article |
| id | doaj-art-10d4dc4febf142f0b674cb280980e265 |
| institution | DOAJ |
| issn | 2673-6101 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Allergy |
| spelling | doaj-art-10d4dc4febf142f0b674cb280980e2652025-08-20T02:52:31ZengFrontiers Media S.A.Frontiers in Allergy2673-61012024-12-01510.3389/falgy.2024.15167741516774Milk ladder: Who? When? How? Where? with the lowest risk of reactionBetul Buyuktiryaki0Ozge Soyer1Duygu Yazici2Duygu Yazici3Gulbin Bingol4Ceren Can5Hikmet Tekin Nacaroglu6Aysen Bingol7Ebru Arik Yilmaz8Metin Aydogan9Cansin Sackesen10Division of Pediatric Allergy, Koc University School of Medicine, Istanbul, TürkiyeDivision of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, TürkiyeResearch Center for Translational Medicine, Graduate School of Health Sciences, Koc University, Istanbul, TürkiyeSwiss Institute of Allergy and Asthma Research (SIAF), Davos, SwitzerlandDivision of Pediatric Allergy, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, TürkiyeDivision of Pediatric Allergy, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Health Sciences University, Istanbul, TürkiyeDivision of Pediatric Allergy, Medipol University School of Medicine, Istanbul, TürkiyeDivision of Pediatric Allergy and Immunology, Akdeniz University School of Medicine, Antalya, TürkiyeDivision of Pediatric Allergy and Immunology, Pamukkale University School of Medicine, Denizli, Türkiye0Division of Pediatric Allergy and Immunology, Kocaeli University School of Medicine, Kocaeli, TürkiyeDivision of Pediatric Allergy, Koc University School of Medicine, Istanbul, TürkiyeThe milk ladder (ML) approach, which is the gradual reintroduction of the milk allergen from the least allergenic forms to the most allergenic forms into the diet of the patients, has been utilized mostly in non-IgE-mediated but in some countries also in IgE-mediated-CMPA due to its possible benefits which include nutrition, quality of life and tolerance induction. Despite increasing interest, so far, there is no guideline on ML; thus, the use of this approach shows discrepancies among healthcare professionals as many factors such as dietary habits, patient history, test results, workload, and facilities of the hospitals, the anxiety of the parents/patients may affect the decision on how, when, where and whom to use ML. Here, we reviewed current data on implementing the ML, suggested a 4-step ML including receipts and amounts, and shared our experience on optimal patient selection, appropriate time and steps for initiating ML, and time intervals between the steps targeting the lowest risk of reaction. We also added the newly developed twice-baked biscotti cake to the ML. We presented the analyses of this product, showing its low allergenicity compared to conventional cake, which provides a safer introduction of milk into the diet.https://www.frontiersin.org/articles/10.3389/falgy.2024.1516774/fullbaked milkcow's milk protein allergyfood allergyfood ladderimmunotherapynutrition |
| spellingShingle | Betul Buyuktiryaki Ozge Soyer Duygu Yazici Duygu Yazici Gulbin Bingol Ceren Can Hikmet Tekin Nacaroglu Aysen Bingol Ebru Arik Yilmaz Metin Aydogan Cansin Sackesen Milk ladder: Who? When? How? Where? with the lowest risk of reaction Frontiers in Allergy baked milk cow's milk protein allergy food allergy food ladder immunotherapy nutrition |
| title | Milk ladder: Who? When? How? Where? with the lowest risk of reaction |
| title_full | Milk ladder: Who? When? How? Where? with the lowest risk of reaction |
| title_fullStr | Milk ladder: Who? When? How? Where? with the lowest risk of reaction |
| title_full_unstemmed | Milk ladder: Who? When? How? Where? with the lowest risk of reaction |
| title_short | Milk ladder: Who? When? How? Where? with the lowest risk of reaction |
| title_sort | milk ladder who when how where with the lowest risk of reaction |
| topic | baked milk cow's milk protein allergy food allergy food ladder immunotherapy nutrition |
| url | https://www.frontiersin.org/articles/10.3389/falgy.2024.1516774/full |
| work_keys_str_mv | AT betulbuyuktiryaki milkladderwhowhenhowwherewiththelowestriskofreaction AT ozgesoyer milkladderwhowhenhowwherewiththelowestriskofreaction AT duyguyazici milkladderwhowhenhowwherewiththelowestriskofreaction AT duyguyazici milkladderwhowhenhowwherewiththelowestriskofreaction AT gulbinbingol milkladderwhowhenhowwherewiththelowestriskofreaction AT cerencan milkladderwhowhenhowwherewiththelowestriskofreaction AT hikmettekinnacaroglu milkladderwhowhenhowwherewiththelowestriskofreaction AT aysenbingol milkladderwhowhenhowwherewiththelowestriskofreaction AT ebruarikyilmaz milkladderwhowhenhowwherewiththelowestriskofreaction AT metinaydogan milkladderwhowhenhowwherewiththelowestriskofreaction AT cansinsackesen milkladderwhowhenhowwherewiththelowestriskofreaction |