Evaluation of the Cow’s Milk and Hen’s Egg Ladder in Daily Practice: A Parent Perspective

Abstract

Aim

Evaluation of the cow’s milk (CM) and hen’s egg (HE) ladder to improve medical care of children with CM and/or HE allergy.

Methods

Through an anonymous retrospective online questionnaire, we investigated parent perspectives regarding the therapy option of a CM and HE ladder in children with CM and/or HE allergy.

Results

Of the 54 families contacted, 29 took part in the study. 19/29 children had already completed the ladders when the survey took place. 19/29 children showed an allergic reaction during the treatment of whom 17 presented skin rashes. 16/29 parents were anxious to rise to the next step in the protocol. 15/29 had difficulties with the implementation of the therapy due to the child refusing the offered food and organizational issues. Medical support as well as the ladder as a therapy option were scored satisfactory.

Conclusion

The participating parents were satisfied with the therapy option and medical care. We identified two main areas for improvement: First, the suggested food for every step should be more diverse, according to the families’ culture background and nutritional needs/demands. Second, to reduce anxiety regarding the therapy, parents must be informed that although allergic reactions are common, they remain mild. Furthermore, we will suggest step changes under medical supervision, especially in families with a slow progression of the food ladder. With these improvements, the duration of therapy could be shortened, thus reducing the risk of an allergic reaction, the need for medical care by an allergist and therefore reducing healthcare costs.

Zusammenfassung

Ziel

Beurteilung der Milch- und Eitreppe zur Verbesserung der medizinischen Versorgung von Kindern mit Kuhmilch (KM)- und/oder Hühnerei (HE)-Allergie.

Methoden

Mithilfe eines anonymen retrospektiven Online-Fragebogens untersuchten wir die Perspektive der Eltern hinsichtlich der Therapieoption einer Milch- und Eitreppe bei Kindern mit KM- und/oder HE-Allergie.

Ergebnisse

Von den 54 kontaktierten Familien haben sich 29 an der Studie beteiligt, wobei 19/29 Kinder die Lebensmitteltreppen bereits abgeschlossen hatten. 19/29 Kinder zeigten während der Therapie eine allergische Reaktion, davon waren 17 kutan. 16/29 Eltern waren besorgt über den Stufenwechsel und 15/29 hatten Schwierigkeiten, die Therapie umzusetzen, da das Kind die angebotenen Nahrungsmittel ablehnte und aus Organisationsgründen. Die medizinische Betreuung sowie die Milch- und/oder Eitreppe als Therapieoption wurden als zufriedenstellend bewertet.

Fazit

Die teilnehmenden Eltern waren mit der Therapiemöglichkeit und der medizinischen Versorgung zufrieden. Wir haben zwei Hauptbereiche für Verbesserungen identifiziert: Die empfohlenen Nahrungsmittel für jeden Schritt sollten vielfältiger sein, entsprechend den kulturellen Bedürfnissen bzw. notwendigen Auslassdiäten der Familien/Patienten. Außerdem sollten die Eltern darüber informiert werden, dass allergische Reaktionen zwar häufig auftreten, aber mild bleiben, um Ängste vor der Therapie zu verringern. Zudem möchten wir vor allem Familien, welche nur langsam mit den Treppen vorankommen, vorschlagen, die Stufenwechsel unter medizinischer Überwachung durchzuführen. Dadurch könnte die Therapiedauer verkürzt werden, um das Risiko einer allergischen Reaktion, die Notwendigkeit einer medizinischen Betreuung durch Allergologen/innen sowie die Gesundheitskosten zu senken.

Keywords

milk ladder - egg ladder - milk allergy - egg allergy - food hypersensitivity - child

Schlüsselwörter

MIlchtreppe - Eitreppe - Kuhmilchallergie - Hühnereiallergie - Lebensmittelallergie - Kind

Publication History

Article published online:
20 January 2025

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