Trial reportThe journal of allergy and clinical immunology. In practice
Increased Tolerance to Less Extensively Heat-Denatured (Baked) Milk Products in Milk-Allergic Children.
Trial report in The journal of allergy and clinical immunology. In practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Oral immunotherapy for cow's milk allergy in children: a systematic review and meta-analysis.Frontiers in immunology · 2025Pooled it
- Tolerance Induction in Cow's Milk Allergic Children by Heated Cow's Milk Protein: The iAGE Follow-Up Study.Nutrients · 2023Trial
- A randomized trial of oral immunotherapy for pediatric cow's milk-induced anaphylaxis: Heated vs unheated milk.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2021Trial
- Different Paths, One Goal: Milk Ladders in IgE- and Non-IgE-Mediated Cow's Milk Protein Allergy-A Narrative Review.Nutrients · 2025Review
- Milk Ladder Efficacy and Safety in IgE-Mediated Cow's Milk Allergy: A Systematic Review and Meta-Analysis of Controlled Studies.Clinical and translational allergy · 2025Review
- Characterizing detectable milk protein allergens β-casein and β-lactoglobulin in milk ladder foods.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2025Article
- Main Processed Hypoallergenic Foods: A Potential Tool to Improve Informed Dietary Choices in Children with IgE-Mediated Food Allergies.Children (Basel, Switzerland) · 2025Review
- Casein sIgE as the most accurate predictor for heated milk tolerance in Finnish children.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2025Article
- The Etiology of IgE-Mediated Food Allergy: Potential Therapeutics and Challenges.International journal of molecular sciences · 2025Review
- The evolution of nutritional care in children with food allergies - With a focus on cow's milk allergy.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025Review
- Effects of Food Processing on Allergenicity.Current allergy and asthma reports · 2025Review
- World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines update - XVI - Nutritional management of cow's milk allergy.The World Allergy Organization journal · 2024Article
- Nutritional and Psychosocial Impact of Food Allergy in Pediatric Age.Life (Basel, Switzerland) · 2024Review
- Practical issues of oral immunotherapy for egg or milk allergy.Clinical and experimental pediatrics · 2024Article
- Milk ladder: Who? When? How? Where? with the lowest risk of reaction.Frontiers in allergy · 2024Review
- The Need for Culturally Appropriate Food Allergy Management Strategies: The Indian Milk Ladder.Nutrients · 2023Article
- Nutritional Strategies for the Prevention and Management of Cow's Milk Allergy in the Pediatric Age.Nutrients · 2023Review
- IgE-mediated cow's milk allergy in Brazilian children: Outcomes of oral food challenge.The World Allergy Organization journal · 2023Article
- Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMost milk-allergic children tolerate baked milk.
objectiveTo investigate the effect of more frequent versus less frequent introduction of higher doses of more allergenic (less heat-denatured) forms of milk (MAFM) on progression to tolerance.
methodsMilk-allergic children were challenged with increasing doses of MAFM; baked foods were incorporated into the diet; challenges were repeated at 6- or 12-month intervals over 36 months.
resultsA total of 136 children (70% males) were enrolled in the active group (median age, 7 years). At baseline, 41 (30%) reacted to muffin, 31 (23%) to pizza, 11 (8%) to rice pudding, 43 (32%) to non-baked milk; and 10 (7%) tolerated non-baked milk. Children who tolerated baked milk but reacted to non-baked liquid milk were randomized to MAFM challenges every 6 months (n = 41) or 12 months (n = 44). At month 36, 61% children in the 6-month and 73% in the 12-month escalation groups tolerated MAFM. Overall, 41 (48%) children who ingested baked-milk diet became tolerant to non-baked milk; no difference was seen between 6- and 12- month escalations. Among children who reacted to muffin at baseline and continued avoidance, 20% developed tolerance to baked milk and 0% tolerated non-baked milk. None of the 34 children who qualified for inclusion but chose not to take part in the active study became tolerant to any form of milk by history.
conclusionsMajority of children tolerated baked milk at baseline. Baked-milk diets were associated with progressive immunomodulation. Most children who incorporated baked milk into their diet progressed to tolerating MAFM, but there was no advantage to more frequent attempts to escalate to MAFM, per intention-to-treat analysis.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.