Benedict's milk allergy at 'high end of the scale'

Benedict Blythe, five, died on 1 December 2021

A consultant who had helped treat Benedict Blythe told the inquest into his death that milk was his only allergy that could have caused a potentially fatal reaction.

The five-year-old was sick and collapsed at Barnack Primary School in December 2021. He was pronounced dead in hospital a short while later.

Dr Shuaib Nasser, a consultant in allergy and asthma, gave evidence at the hearing in Peterborough Town Hall on Thursday.

Dr Nasser, who had helped Benedict deal with his allergies since he was a baby, said the youngster had suffered multiple allergic reactions triggered by milk during his life.

Benedict Blythe went to Barnack Primary School, between Peterborough and Stamford

He said Benedict, from Stamford, Lincolnshire, also had what he considered to be "uncontrolled asthma".

The consultant told the inquest, which opened on Monday and is expected to last for two weeks, that an allergic reaction "does depend on the amount of allergen ingested, but also depends on the sensitivity of the child and also co-factors... for example, asthma".

He said the severity of Benedict's cow's milk allergy was "at the high end of the scale" and he "was amongst children with the most severe milk allergy".

He added: "My conclusion was milk was the only food allergy that Benedict had that was capable of causing a potentially fatal allergic reaction."

Benedict had an anaphylactic reaction and collapsed at school, the inquest has heard

Area coroner Elizabeth Gray previously told the hearing that Benedict had been kept off school on 30 November after being sick the night before.

He went back on 1 December after his mother Helen, who gave evidence on Monday, said he "was fine and didn't appear to be unwell".

That day, while outside with other children during morning break, Benedict ate a gingerbread biscuit he had taken with him from home, the inquest heard.

He then returned to the classroom, where he was offered oat milk but was said to have refused it.

He fell ill shortly after that and was later pronounced dead at Peterborough City Hospital. He died from food-induced anaphylaxis.

On Wednesday, head teacher Amy Jones explained that Benedict's oat milk was in a labelled carton provided by his parents and kept in a staff fridge.

There was another child in the class who had lactose-free milk, and his milk was kept in the same fridge as Benedict's.

On Thursday, Dr Nasser told the hearing that lactose-free milk was "just as allergenic to a child who is allergic to cow's milk".

Asked whether, if the milk lids had been swapped, it would have been enough to cause an allergic reaction, he replied: "It's unlikely that the lid was the source of the contamination."

'Severe reactions'

Dr Nasser, from Cambridge University Hospitals NHS Foundation Trust, said Benedict's allergy became clear when he began weaning at four months old.

"It became clear very quickly that he was allergic to milk – and not only allergic but [he] had quite severe reactions," Dr Nasser said.

Benedict was on a "milk ladder" in the early years of his life, with the aim of increasing his tolerance to foods containing milk. But in 2019, he had "quite a severe reaction" to one spoon of cow's milk, Dr Nasser said, and the ladder was stopped in 2020.

Benedict had further severe allergic reactions in 2021, and a reaction in October that year was "a strong indication that his tolerance had reduced", Dr Nasser said.

Benedict vomited and developed breathing problems when he ingested cow's milk protein.

Dr Nasser said: "If you saw vomiting in isolation... you wouldn't assume it's due to allergies at all. It's the constellation of symptoms and signs together that would lead to the assumption of an allergic reaction."

Asked whether it would have been obvious to observers on this occasion that it was a severe allergic reaction, he said: "If you had personally seen Benedict have an allergic reaction in the past and vomiting was a symptom, you would have to assume it was an allergic reaction, absolutely."

Dr Nasser said an adrenaline pen should be administered as early as possible when anaphylaxis was recognised.

He said: "In hindsight, yes it was administered too late. If it had been administered immediately and he still would have died, would it have been administered too late?"

The inquest continues.

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