Alabama Boy, 3, Dies of Severe Reaction During Baked Milk Challenge Test

in Food Allergy, Milk & Egg
Published: August 2, 2017

A 3-year-old Alabama boy has tragically died following a severe anaphylatic reaction. The boy named Alastair had multiple food allergies, including dairy, as well as asthma.

His mother Pamela wrote to Allergic Living that her son’s symptoms of anaphylaxis began as he taking part in a food challenge – a test to see whether he could tolerate food that contains baked milk. Alastair passed away on July 30, 2017. The baked milk challenge took place at Children’s Hospital of Alabama in Birmingham.

The grieving parents held Alastair’s funeral on August 2, 2017. Pamela was seeking to find out more about the reasons for the tragedy. “It is my understanding that this has never happened before. I was not warned of this possibility.”

A Family’s Grief

In his obituary, the family describes their son, who would have turned 4 years old in August 2017, as “Alastair X, Super Hero.” They say that he lost his life “during the course of his tireless crusade against his arch nemesis – childhood asthma and allergies.” They mention that Alastair “leaves behind his adorable sidekick and little brother,” as well as extended family.

Supervised baked milk challenges are done to see whether a dairy-allergic child’s immune system can tolerate extensively baked foods, which allows for the widening of the diet. In those with appropriate allergy test scores, studies show the challenges have had a good track record of success. So Alastair’s tragedy comes as particularly shocking news to the food allergy community.

Allergists on Safety

Update: After this article was published, three leading allergist organizations issued a statement, expressing sympathy for Alastair’s family and reminding of the following safety information:

“Oral food challenges should only be conducted when the following steps have been taken, which help to ensure patient safety to the greatest extent possible:

  • They are conducted by a provider who is well-trained and experienced with food allergy and anaphylaxis management, has experience in performing an oral food challenge, and there is an established procedure for conducting the challenge.
  • There is a proper office or hospital-based set-up, which includes a procedure for preparing and administering the food item by well-trained and experienced staff; layered supervision for the patient, including dedicated nursing and a supervising medical provider close by; a plan for treatment of any resulting reaction; and a post-feeding patient observation period. Resuscitation equipment must be available in case it is needed.
  • Documentation of informed consent prior to the challenge should detail that the risks and benefits of the procedure were explained to the patient or caregiver, and that these risks were understood.
  • A plan for advising the patient after the procedure based on the outcome.”

Here is the allergists’ full statement.

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18 Things To Know About Food Allergy Reactions