Allergy, Asthma & Clinical Immunology (Jun 2022)

Patient selection for milk and egg ladders using a food ladder safety checklist

  • Gilbert T. Chua,
  • Edmond S. Chan,
  • Joanne Yeung,
  • Scott B. Cameron,
  • Lianne Soller,
  • Brock A. Williams,
  • Alanna Chomyn,
  • Timothy K. Vander Leek,
  • Elissa M. Abrams,
  • Raymond Mak,
  • Tiffany Wong

DOI
https://doi.org/10.1186/s13223-022-00696-w
Journal volume & issue
Vol. 18, no. 1
pp. 1 – 5

Abstract

Read online

Abstract A food ladder is a form of home-based dietary advancement therapy that gradually increases exposure to an allergenic food through the gradual introduction of egg or milk containing food with increasing quantity and allergenicity from extensively heated forms, such as baked goods, to less processed products. While widely considered safe, the food ladder is not risk-free and most of the egg and milk ladder studies only included preschoolers with mild egg and milk allergies, and with no or well-controlled asthma. We propose a Food Ladder Safety Checklist to assist with patient selection using “4 A's” based on available evidence for food ladders, including Age, active or poorly controlled Asthma, history of Anaphylaxis, and Adherence.

Keywords