Anaphylactic Reaction to Milk in an Infant

THE CASE: On the morning of the day this picture was taken, this infant suddenly turned blue and stopped breathing while being fed. His mother called EMS and started CPR. The child immediately began to breathe again after violent coughing. By the time EMS arrived, the child was breathing normally and his color was also normal. EMS personnel thought the call was a prank until the mother placed a single drop of cow's milk on the child's lower lip. Within 15 seconds, the lip became erythematous and swollen.

Which of the following statements is NOT true?

• A. An anaphylactic reaction may occur in infants.

• B. Food is the most likely offending factor.

• C. Oral challenge of offending foods without medical supervision is very risky and should be discouraged.

• D. The child will almost certainly outgrow his allergy to milk protein.