Trailblazing Kids Desensitize to Dairy Allergy
In May 2008, kindergarten pupil Ethan Johnston had a frightening anaphylactic reaction to yogurt when a dribble of a classmate’s snack splashed onto his lunch. Yet, incredibly, these days, Ethan drinks a milkshake every evening before bedtime at his home in Camrose, Alberta. How can this be? The 7-year-old, who still doesn’t even like the taste of milk, is a participant in a groundbreaking program that three allergists at the University of Alberta have adapted from an experimental therapy developed by Italian researchers.
“I can’t believe it,” says Kristie Johnston, Ethan’s mom. “A year ago, he had anaphylaxis to milk, and now he’s drinking milk straight.”
Ethan is a patient of pediatric allergist Dr. Stuart Carr. In late 2007, Carr and Edmonton colleagues Dr. Timothy Vander Leek and Dr. Per Lidman began offering milk desensitization treatment, also called oral immunotherapy, to young patients who have a serious allergy to cow’s milk.
The aim is to build up tolerance to dairy protein through the consumption of precisely measured, slowly increasing doses over a period of at least six months. It starts with just one drop of a diluted milk solution.
Ethan’s success story is shared by most of the 20 patients taking part in the Edmonton milk therapy. But when speaking to the families involved, it becomes clear that this breakthrough allergy treatment comes with significant hurdles, with the most daunting being the emotional challenges of desensitization.
After all, these children are purposely swallowing (albeit in tiny amounts) a food known to cause them severe and frightening allergic reactions. “The psychological aspect of this is profound,” says Stephanie Wanner, whose 5-year-old son Josh Bjorndahl began the dairy treatment in January.
Josh had his initial oral challenge in Dr. Timothy Vander Leek’s office. “I felt horrible because I knew he was going to react,” says Wanner. Sure enough, the boy drank one millilitre of milk, and hives immediately popped up on his skin, he vomited, and the doctor gave him a shot of adrenaline within a minute.
Yet, less than a month later, Josh was able to start taking small, diluted milk doses at home. With those doses, the boy’s main side effect was an itchy mouth, but that eventually disappeared. Then, three months into the regime, Josh’s stomach began to hurt after taking his daily milk dose.
“He would cry about his sore tummy. Then you feel the guilt and wonder, ‘Am I doing the right thing?’” says his mother. “To have him sit in your lap and cry, you need to be committed. If you can’t handle that and still go on, there’s no point in starting.”
The beginning was by far the worst. But as Josh progressed to slightly higher doses, “the more he became motivated. He was starting to see the effects,” says Wanner.