Children who have a potentially life-threatening allergy to cow's milk can often "learn" to tolerate milk through a carefully orchestrated, supervised programme in which they sample milk in progressively higher doses, research suggests.
After one year, more than one-third of cow's milk-allergic children who completed the programme hadbecome completely tolerant to cow's milk and more than half could tolerate limited amounts of milk, the research team reports in the Journal of Allergy and Clinical Immunology.
"Desensitisation, or specific oral tolerance induction, can be achieved in a significant percentage of children with very severe allergic reactions," Dr Egidio Barbi, from children's hospital Burlo Garofolo, University of Trieste, said.
Current strategies for managing children with severe food allergy - avoiding the food entirely and carrying epinephrine auto-injectors to quickly halt an allergic reaction - are only partially effective and have a negative impact on quality of life for the entire family, Barbi and his colleagues point out.
Their strategy consisted of two phases. During phase one, the children spent 10 days in the hospital where they were given drops of diluted milk in increasing doses and concentration each day. During phase two, the children followed a similar protocol at home and parents were taught how to spot and treat any allergic reactions.
After one year, 11 of the 30 children who completed the protocol were able to tolerate cow's milk and dairy products without any restrictions.
Moreover, another 16 children who completed the desensitisation programme were able to tolerate limited amounts of cow's milk, resulting in a "striking improvement in quality of life", the investigators note.
The fact that most of the children could tolerate at least some cow's milk after the protocol "is important because the danger associated with accidental exposure to small amounts of cow's milk is significantly reduced", they write.
Three children who had persistent allergic symptoms were not able to complete the programme.
"Desensitisation carries a definite risk of reactions, especially in children with a severe history," Barbi said. "For this reason, it should be restricted to highly defined medical settings."
Barbi and colleagues warn that "far more research is needed to confirm the safety of this approach".
