By the time her daughter Reagan was a few months old, Lissa Roberts suspected the extreme eczema she was experiencing had something to do with foods. Indeed, a RAST (radioallergosorbent) test ordered by Reagan’s pediatrician identified allergies to eggs, milk and peanuts.  And, like most parents of children with food allergies, Roberts was told to avoid the culprits – especially milk – treat reactions when they occur, and wait for the child to outgrow the allergy. That scenario seemed extremely stressful, considering that Reagan’s reactions could be severe and even life-threatening. Also, avoidance would be no easy chore given the prevalence of milk products in everything from crackers to spaghetti sauce.

“From then on we moved forward very cautiously,” Roberts says. “No pizza, no ice cream socials, and we took our own food and hand wipes to every birthday party.”

The Roberts’ experience is one that Hopkins Children’s immunologist Robert Wood has seen countless times. Noting that “the quality of life of a child with food allergy is comparable to the quality of life of a child with diabetes,” he has been determined to develop therapies that go beyond strict food avoidance or waiting for the child to outgrow the allergy. And he took a significant step in that direction in a recent study that showed giving children with milk allergies increasingly higher doses of milk over time may ease and even help them completely overcome their allergic reactions (Journal of Allergy & Clinical Immunology, Oct. 28, 2008).

“Our findings suggest that oral immunotherapy gradually retrains the immune system to completely disregard or to better tolerate the allergens in milk that previously causes allergic reactions,” says Wood.

In the study, Wood explains, he and fellow researchers followed over four months allergic reactions among 19 children – ages 6 to 17 – with severe and persistent milk allergy. Of the 19 patients, 12 received progressively higher doses of milk protein, and seven received placebo. At the onset of the study, the children were able to tolerate on average only 40 mg, or about a quarter of a teaspoon, of milk. But at the study’s end, the children who had been receiving increasingly higher doses of milk protein were able to tolerate a median dose of over 5 ounces of milk, without any allergic reaction or with mild symptoms like mouth itching or minor abdominal discomfort. Those who had been getting the placebo were unable to tolerate doses higher than 40 mg without having an allergic reaction.

“Albeit preliminary and requiring further study,” Wood says, “these results suggest that oral immunotherapy may be the closest thing yet to a true treatment for food allergy.”

Wood notes that the tolerance in children treated with milk continued to build over time, and recommends that these children, with close monitoring by their parents and doctors, continue to consume milk daily to maintain their tolerance. He adds that future studies, like this one, must be pursued with extreme caution as patients are at risk of serious reactions. Immunotherapy is designed for patients who, based on family history and testing, will likely not outgrow their food allergies – about 20 percent of all kids with milk allergy, including Reagan Roberts, who participated in the study.

“It was stressful, but looking back it was well worth it,” says Lissa Roberts. “We’re not scared of milk anymore.”

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