AAIR Charity Sir Stephen Holgate Awards
The AAIR Charity is delighted to award Samantha with the AAIR Charity Sir Stephen Holgate Award. These awards are made annually to students who have excelled in their dissertation projects.
Student: Samantha Blamires
Samantha is the Clinical Lead Dietitian for Paediatric Allergy at St Mary’s Hospital, London. Her journey into paediatric allergy was both personal and professional, sparked by her own child’s diagnosis of milk allergy. This experience inspired her to complete an MSc in Allergy at the University of Southampton, an achievement made possible through bursaries awarded by the Natasha Allergy Research Foundation. Sam graduated top of her class, receiving the Dean’s List Award for Outstanding Achievement, and credits the MSc with equipping her with the knowledge and skills required to deliver high-quality care to children and their families living with complex food allergy.
With a strong foundation in paediatric dietetics and a deep understanding of multi-system allergic disease, Sam now leads specialist clinics and contributes to the development of dietetic-led allergy services. She is passionate about improving allergy education nationwide and holds Associate Fellowship status with Advance HE. In recognition of her work, she was awarded the Anthony Frew Award for Excellence in Allergy Education by the British Society for Allergy and Clinical Immunology. Whether in clinic, research, or teaching, Sam is dedicated to ensuring families feel confident and supported in managing food allergies.
Title of MSc Project: Are milk ladders created equal? A biochemical analysis of milk ladder foods.
Milk allergy is common in the UK. Milk ladders are widely used to support the (re)introduction of cow’s milk in the diets of milk-allergic children, progressing from extensively heated to unheated forms. These ladders have, in general, been devised based on theoretical estimates of cow’s milk protein content and the assumed impact of heat-treatment and matrix effects on allergenicity. This has led to a pragmatic and practical approach to cow’s milk introduction, however the ‘ladder steps’ lack quantification and standardisation, especially with regards to the amount of specific cow’s milk proteins at each step – something that is important to maximise safety of ladders.
This study provides the most extensive biochemical analysis of foods used in milk ladders to date, examining the presence of total and specific milk proteins, including β-lactoglobulin, β-casein, and total caseins. Caseins are of particular importance, as IgE to casein has been identified as a marker for persistent cow’s milk allergy and baked milk reactivity. Our findings revealed discrepancies between the assumed order of some foods and their actual protein content per portion, highlighting the potential for mismatches between estimated and actual allergen exposure.
On the basis of these findings, we proposed a modified milk ladder that sequentially increases exposure to clinically relevant milk proteins for pre-defined portion sizes. This approach offers a more evidence-based approach for guiding the safe graded reintroduction of milk. By using biochemical data to inform clinical practice this work aims to improve both the safety and effectiveness of milk ladders to reduce dietary restrictions in children with cow’s milk allergy.