PURPOSE OF THE STUDY.
Baked goods are a frequent cause of allergic reactions in food-allergic children. The goal of this study was to describe the frequency of allergic reactions to such foods among food-allergic children, characterize the ability of employees of bakery shops to give advice about safe food choices, and to determine the rate of detectable cow’s milk protein in bakery products recommended as “cow’s milk–free.”
Parents of children with food allergy and staff of 50 bakery shops in Berlin, Germany.
A standardized questionnaire was sent to 200 families of food-allergic children to capture demographic information, frequency, and severity of allergic reactions to non-pre-packaged foods from different food businesses and type of allergen information parents received most often when buying non-pre-packaged foods from these establishments. Staff members from 50 bakery shops were interviewed with an 8-item questionnaire that inquired about frequency of customers with food allergies, advice given by staff, and whether staff received any training about food allergy. Bakery products recommended as “cow’s milk–free” were then purchased, and cow’s milk protein levels were measured by enzyme-linked immunoassay.
One hundred and four (52%) parents responded; 43% reported that their child had at least 1 allergic reaction after eating a non-pre-packaged food, with 25% experiencing an allergic reaction to a bakery product. Regarding the bakery staff interviews, 84% said they were able to advise food allergic customers, but only 52% had received any training about food allergy. Of 73 bakery products sold as “cow’s milk–free,” 43% had detectable levels of cow’s milk, including 35% of savory products and 62% of sweet pastry products, and 21% of all products contained more than 3 mg of cow’s milk protein per serving.
This study found that allergic reactions to non-pre-packaged foods, particularly baked goods, are common. Despite the fact that most bakery staff felt able to advise food-allergic families, almost half of products recommended as “cow’s milk–free” contained milk protein and about 1 in 5 contained clinically relevant amounts.
Although this study was performed in a single European city, we might expect similar results in American settings. This study highlights the risks of consuming non-pre-packaged bakery products for children with relevant food allergies and suggests that children and their families need to use caution with these bakery products. In many cases, patients reactive to heated (baked) milk cannot safely rely on bakery staff for advice about allergen-safe products.
- Copyright © 2015 by the American Academy of Pediatrics