Maryelle and other very wise ones, I have a breastfeeding cow's milk allergic pateint who is approaching her first birthday. I plan on orally challenging her at one year old. This pateint presented at 2-3 months old while exclusively BF with blood in stools, increasd eosinophils on white count and inflamatory changes on colon biopsy. With mom on a completely cow's casein and whey free diet all is well. I think this mom is a saint. Some questions; I got different opinions from ID and GI specailist as to challenging this baby at the one year well visit on the same day she gets HiB and chicken pox vaccines. GI specialist concerned of possible immunization reaction being confused as cow's milk reaction. ID specailist not concerned with these vaccines. Usually Ive done these challenges by giving the baby 1 once (30 cc) of cows milk and observing her for 2 hours in the office. If this works all is well. However in this baby's case could she have matured to the point of not being allergic to cow's milk protien that would be passed in BM if mom comsumed it but still allergic to cow's milk that she herself would directly consume? (I have a different pateint who fits this discription, hives to cow's milk formula). If so can she be challenged by having mom consume the cow's milk then breastfed 2-3 hours later? If we did this and baby reacted how long most mom then avoid breastfeeding her? thanks, -Rob (pediatrician Wilkes Barre, PA)