About 60-70% of children with an immediate cow milk allergy can tolerate baked milk products. It is thought that the high heat denatures the milk proteins rendering it less allergenic. It appears children who have asthma and multiple food allergies (> 2-3 separate food immediate food allergies) are more likely to react to baked milk. It does not appear that the size of the skin test or RAST blood test to cow’s milk can accurately predict those that will/will not tolerate baked milk.
It remains unclear whether exposure to baked milk accelerates tolerance to cow milk, but many parents report that it does make their life significantly easier.
It is very important that such challenges to baked milk are not done at home, since it is not possible to accurately predict who can tolerate baked milk and some children can react severely, with anaphylaxis. Hence such challenges need to be done under medical observation wtih resuscitation equipment and by staff experienced in food challenges. Often baked milk challenges in Australia are performed by using a standard muffin mix.
Next time – cow’s milk FPIES.