Q:

4/17/2013
I am looking for handouts on course number 2313 at the 2013 conference. I need the muffin challenge recipe.

A:

Thank you for your inquiry.

To obtain the handouts you wish to have, please click on “Annual Meeting” at the top of the screen; then click on “Handouts.” You can search for the handouts in question from this site using your login information.

In the meantime, I am sending you recipes (see below) for muffin challenges which have appeared in previous entries posted on our “Ask the Expert” website.

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

12/2/2012
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 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).

1/27/2012
Below you will find (copied from the source) the protocol for a baked milk challenge according to the method employed at Mt. Sinai. The specific reference is also noted below.

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

"Heated milk challenges were performed openly under physician supervision in the Mount Sinai General Clinical Research Center. Each muffin and waffle contained 1.3 g milk protein (nonfat dry milk powder; Nestle Carnation, Glendale, Calif). The muffin was baked at 350°F for 30 minutes in an oven, and the waffle (<0.625 inches thick to ensure thorough heating) was cooked in a waffle maker at approximately 500°F for 3 minutes. Each food was administered in 4 equal portions over 1 hour. The muffin was served first; if no symptoms were observed, 2 hours later, the waffle was served. Subjects were monitored throughout and for 2 to 4 hours after the completion of the final challenge. Challenges were discontinued at the first objective sign of reaction, and treatment was initiated immediately." SOURCE: The Journal of Allergy and Clinical Immunology, Volume 122, Issue 2, Pages 342-347.e2, August 2008.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology