PDF(Pubmed)
Abstract：
In regard to cow\'s milk allergy, the current option of avoiding can be expanded by (re-)introducing milk using a milk ladder. So-called \"food ladders\" are internationally well known and utilized for both non-IgE-mediated and IgE-mediated cow\'s milk allergy. Stepping up the stairs from highly processed baked goods with milk via cooked milk products to pasteurized fresh milk reflects the status of acquired tolerance of each level. The allergenicity of milk depends on processing and amount. By implementing the milk ladder, it can enhance the clinical process of tolerance development, lead to meeting nutrient requirements quickly, and involve parents actively in the therapeutical process. The milk ladder, for the first time being published and adapted for Germany, describes a structured framework that might be adapted individually regarding the time period on a certain level or other variations such as preparation/amount of milk products. From a safety perspective, healthcare professionals should pay great attention to patient selection and education prior to implementing the milk ladder. Detailed advice as well as recipes and a graphical presentation can be found in the supplemental material.
摘要：
关于牛奶过敏，可以通过使用牛奶梯子（重新）引入牛奶来扩展当前的避免选择。所谓的“食物阶梯”是国际上众所周知的，用于非IgE介导的和IgE介导的牛奶过敏。从经过煮熟的奶制品的高度加工的烘焙食品到经过巴氏杀菌的新鲜牛奶的楼梯，反映了每个级别的获得性耐受性的状态。牛奶的过敏原性取决于加工和数量。通过实施牛奶阶梯，它可以增强耐受性发展的临床过程，导致快速满足营养需求，让父母积极参与治疗过程。牛奶梯子，第一次为德国出版和改编，描述了一种结构化框架,其可以在一定水平上关于时间段或其他变化(诸如奶制品的制备/量)单独地进行调整。从安全的角度来看,在实施牛奶阶梯之前，医护人员应高度重视患者的选择和教育。详细的建议以及食谱和图形演示可以在补充材料中找到。
