Q:

12/2/2012
Can you please refer me to recipes to orally challenge patients in clinic for baked egg and baked milk? We are currently using the one from Johns Hopkins and it doesn't seem to bake or taste well. Thank you.

A:

Thank you for your inquiry.

You will find in the Lieberman JA, et al., article noted below, a recipe for baked egg oral food challenges. This recipe is on the online appendix. It is too extensive for us to copy here, but anyone with a subscription to The Journal of Allergy and Clinical Immunology can pull up the recipe online and print it for you.

I have also copied below a recipe for baked milk and baked cheese taken from the Kim JS, et al., article cited below.

Both of these recipes are used at Mount Sinai Hospital and developed at the Jaffe Food Allergy Institute.

Thank you again for your inquiry and we hope this response is helpful to you.

Baked egg:
J Allergy Clin Immunol. 2012 Jun;129(6):1682-4.e2.
Outcomes of 100 consecutive open, baked-egg oral food challenges in the allergy office.
Lieberman JA, Huang FR, Sampson HA, Nowak-Wêgrzyn A.

Baked milk:
Source:
J Allergy Clin Immunol. 2011 Jul;128(1):125-131.e2. Epub 2011 May 23.Dietary baked milk accelerates the resolution of cow's milk allergy in children
Kim JS, Nowak-Wêgrzyn A, Sicherer SH, Noone S, Moshier EL, Sampson HA.
Baked milk Each muffin contained 1.3 g of milk protein (nonfat dry milk powder; Nestle Carnation, Glendale, Calif). The muffin was baked at 350°F for 30 minutes. Baked milk-tolerant subjects were instructed to ingest 1 to 3 servings per day of store-bought baked milk products with milk listed as a minor ingredient or home-baked products with an equivalent amount of milk protein.

Baked cheese Amy's cheese pizza (Amy's Kitchen, Inc, Petaluma, Calif), containing 4.6 g of milk protein, was baked at 425°F for 13 minutes or longer. Baked cheese-tolerant subjects were instructed to eat any brand of well-cooked cheese pizza 4 to 7 times weekly and limited to 1 daily serving.

Unheated milk Challenges were performed with skim milk totaling 240 mL (or other product containing 8-10 g of unheated milk protein, such as yogurt).

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology