Milk ladder: who? when? how? where? with the lowest risk of reaction

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dc.contributor.authorBüyüktiryaki, Betül
dc.contributor.authorSoyer, Özge
dc.contributor.authorBingöl, Gülbin
dc.contributor.authorCan, Ceren
dc.contributor.authorNacaroğlu, Hikmet Tekin
dc.contributor.authorBingöl, Ayşen
dc.contributor.authorSaçkesen, Cansın
dc.date.accessioned2025-12-16T13:13:59Z
dc.date.available2025-12-16T13:13:59Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
dc.description.abstractThe milk ladder (ML) approach, which is the gradual reintroduction of the milk allergen from the least allergenic forms to the most allergenic forms into the diet of the patients, has been utilized mostly in non-IgE-mediated but in some countries also in IgE-mediated-CMPA due to its possible benefits which include nutrition, quality of life and tolerance induction. Despite increasing interest, so far, there is no guideline on ML; thus, the use of this approach shows discrepancies among healthcare professionals as many factors such as dietary habits, patient history, test results, workload, and facilities of the hospitals, the anxiety of the parents/patients may affect the decision on how, when, where and whom to use ML. Here, we reviewed current data on implementing the ML, suggested a 4-step ML including receipts and amounts, and shared our experience on optimal patient selection, appropriate time and steps for initiating ML, and time intervals between the steps targeting the lowest risk of reaction. We also added the newly developed twice-baked biscotti cake to the ML. We presented the analyses of this product, showing its low allergenicity compared to conventional cake, which provides a safer introduction of milk into the diet.
dc.identifier.citationBüyüktiryaki, B., Soyer, Ö., Bingöl, G., Can, C., Nacaroğlu, H. T., Bingöl, A. ... Saçkesen, C. (2024). Milk ladder: who? when? how? where? with the lowest risk of reaction. Frontiers in Allergy, 5. http://dx.doi.org/10.3389/falgy.2024.1516774
dc.identifier.doi10.3389/falgy.2024.1516774
dc.identifier.issn2673-6101
dc.identifier.pmid39713044
dc.identifier.scopus2-s2.0-85212681407
dc.identifier.scopusqualityQ2
dc.identifier.urihttp://dx.doi.org/10.3389/falgy.2024.1516774
dc.identifier.urihttps://hdl.handle.net/20.500.12511/13342
dc.identifier.volume5
dc.identifier.wosWOS:001381145500001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorNacaroğlu, Hikmet Tekin
dc.institutionauthorid0000-0003-1333-2648
dc.language.isoen
dc.relation.ispartofFrontiers in Allergy
dc.relation.publicationcategoryDiğer
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectBaked Milk
dc.subjectCow's Milk Protein Allergy
dc.subjectFood Allergy
dc.subjectFood Ladder
dc.subjectImmunotherapy
dc.subjectMEDICINE::Physiology and pharmacology::Physiology::Nutrition
dc.subjectTolerance Induction
dc.subjectTreatment
dc.titleMilk ladder: who? when? how? where? with the lowest risk of reaction
dc.typeOther

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