Canadian food ladders for dietary advancement in children with IgE-mediated allergy to milk and/or egg

Alanna Chomyn, Edmond S Chan, Joanne Yeung, Timothy K Vander Leek, Brock A Williams, Lianne Soller, Elissa M Abrams, Raymond Mak, Tiffany Wong, Alanna Chomyn, Edmond S Chan, Joanne Yeung, Timothy K Vander Leek, Brock A Williams, Lianne Soller, Elissa M Abrams, Raymond Mak, Tiffany Wong

Abstract

Food ladders are clinical tools already widely used in Europe for food reintroduction in milk- and egg-allergic children. Previously developed milk and egg ladders have limited applicability to Canadian children due to dietary differences and product availability. Herein we propose a Canadian version of cow's milk and egg food ladders and discuss the potential role that food ladders may have in the care of children with IgE-mediated allergies to cow's milk and/or egg, as either a method of accelerating the acquisition of tolerance in those who would outgrow on their own, or as a form of modified oral immunotherapy in those with otherwise persistent allergy.

Keywords: Cow’s milk allergy; Egg allergy; Food allergy; Food ladders; Oral immunotherapy.

Conflict of interest statement

ESC has received research support from DBV Technologies; has been a member of advisory boards for Pfizer, Pediapharm, Leo Pharma, Kaleo, DBV, AllerGenis, Sanofi Genzyme, Bausch Health, Avir Pharma; is a member of the healthcare advisory board for Food Allergy Canada; and was co-lead of the CSACI oral immunotherapy guidelines. JY received speaking honoraria from UBC CPD, Sanofi, AstraZeneca, Pfizer, Stallergenes Greer, Novartis, Pediapharm, Medexus Pharma. She has served on advisory/consultancy committees for Sanofi, Pfizer, HealthLinkBc, Stallergenes Greer, and LEO Pharma. TV has served on advisory boards and received honoraria from Aralez, Bausch Health, and Pfizer. EA served on the Healthcare advisory board, and Food Allergy Canada. She received moderator/speaker fees from Novartis, GSK, and AstraZeneca. RM was a moderator/speaker for Astra Zeneca, Pediapharm, and Novartis. He has been on advisory boards for Sanofi, and ALK.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Canadian egg ladder
Fig. 2
Fig. 2
Canadian  milk ladder

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Source: PubMed

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