Safety and effectiveness of the Canadian food ladders for children with IgE-mediated food allergies to cow’s milk and/or egg

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dc.contributor.authorChomyn, Alanna
dc.contributor.authorChan, Edmond S.
dc.contributor.authorYeung, Joanne
dc.contributor.authorCameron, Scott
dc.contributor.authorChua, Gilbert T.
dc.contributor.authorVander Leek, Timothy K.
dc.contributor.authorWilliams, Brock A.
dc.contributor.authorSoller, Lianne
dc.contributor.authorAbrams, Elissa
dc.contributor.authorMak, Raymond
dc.contributor.authorWong, Tiffany
dc.date.accessioned2023-12-06T21:40:50Z
dc.date.available2023-12-06T21:40:50Z
dc.date.issued2023-11-06
dc.date.updated2023-12-01T04:27:50Z
dc.description.abstractBackground Food ladders are tools designed to facilitate home-based dietary advancement in children with food allergies through stepwise exposures to increasingly allergenic forms of milk and egg. Several studies have now documented safety and efficacy of food ladders. In 2021, we published a Canadian adaptation of the previously existing milk and egg ladders originating in Europe using foods more readily available/consumed in Canada. Our study adds to the growing body of evidence supporting food ladder use and provides safety and effectiveness data for our Canadian adaptation of the milk and egg ladders. Methods Surveys were distributed to families of children using the Canadian Milk Ladder and/or the Canadian Egg Ladder at baseline, with follow up surveys at 3 months, 6 months, and 12 months. Data were analyzed using REDCap and descriptive and inferential statistics are presented. Results One hundred and nine participants were started on milk/egg ladders between September 2020 and June 2022. 53 participants responded to follow up surveys. Only 2 of 53 (3.8%) participants reported receiving epinephrine during the study. Severe grade 4 reactions (defined according to the modified World Allergy Organization grading system) were not reported by any participants. Minor cutaneous adverse reactions were common, with about 71% (n = 10/14) of respondents reporting cutaneous adverse reactions by 1 year of food ladder use. An increasing proportion of participants could tolerate most foods from steps 2–4 foods after 3, 6, and 12 months of the food ladder compared to baseline. Conclusion The Canadian food ladders are safe tools for children with cow’s milk and/or egg allergies, and participants tolerated a larger range of foods with food ladder use compared to baseline.
dc.identifier.citationAllergy, Asthma & Clinical Immunology. 2023 Nov 06;19(1):94
dc.identifier.doi10.1186/s13223-023-00847-7
dc.identifier.urihttp://hdl.handle.net/1993/37852
dc.language.isoeng
dc.language.rfc3066en
dc.publisherBMC
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.subjectfood ladders
dc.subjectfood allergy
dc.subjectcow's milk allergy
dc.subjectegg allergy
dc.subjectoral immunotherapy
dc.titleSafety and effectiveness of the Canadian food ladders for children with IgE-mediated food allergies to cow’s milk and/or egg
dc.typeletter
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Pediatrics and Child Health
oaire.citation.issue94
oaire.citation.titleAllergy, Asthma & Clinical Immunology
oaire.citation.volume19
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