consumers, especially as there can be many variations on the wording of the warning. as of 2014, pal is regulated only in switzerland, japan, argentina, and south africa. argentina decided to prohibit precautionary allergen labeling since 2010, and instead puts the onus on the manufacturer to control the manufacturing process and label only those allergenic ingredients known to be in the products. south africa does not permit the use of pal, except when manufacturers demonstrate the potential presence of allergen due to cross-contamination through a documented risk assessment despite adherence to good manufacturing practice. in australia and new zealand, there is a recommendation that pal be replaced by guidance from vital 2.0 (vital incidental trace allergen labelling). a review identified "the eliciting dose for an allergic reaction in 1% of the population" as 0.01 mg for cow's milk. this threshold reference dose (and similar results for egg, peanut and other proteins) will provide food manufacturers with guidance for developing precautionary labelling and give consumers a better idea of what might be accidentally in a food product beyond "may contain." vital 2.0 was developed by the allergen bureau, a food industry-sponsored, non-government organization. the eu has initiated a process to create labeling regulations for unintentional contamination but it is not expected to be published before 2024. lack of compliance with labeling regulations is also a problem. as an example, the fda documented failure to list milk as an ingredient in dark chocolate bars. the fda tested 94 dark chocolate bars for the presence of milk. only six listed milk as an ingredient, but of the remaining 88, the fda found that 51 of them actually did contain milk proteins. many of those did have pal wording such as "may contain dairy." others claimed to be "dairy free" or "vegan" but still tested positive for cow's milk proteins. in brazil, since april 2016, the declaration of the possibility of cross-contamination is mandatory when the product does not intentionally add any allergenic food or its derivatives, but the good manufacturing practices and allergen control measures adopted are not sufficient to prevent the presence of accidental trace amounts. milk of all species of mammalians is included among these allergenic foods. society and culture food fear has a significant impact on quality of life. for children with allergies, their quality of life is also affected by the actions of their peers. an increased occurrence of bullying has been observed, which can include threats or deliberate acts of forcing allergic children to contact foods that they must avoid or intentional contamination of allergen-free food. research desensitization, which is a slow process of consuming tiny amounts of the allergenic protein until the body is able to tolerate more significant exposure, results in reduced symptoms or even remission of the allergy in some people and is being explored for treatment of milk allergy. this is called oral immunotherapy (oit). sublingual immunotherapy, in which the allergenic protein is held in the mouth under the tongue, has been approved for grass and ragweed allergies, but not yet for foods. oral desensitization for cow's milk allergy appears to be relatively safe and may be effective, however further studies are required to understand the overall immune response, and questions remain open about duration of the desensitization. there is research – not specific to milk allergy – on the use of probiotics, prebiotics and the combination of the two (synbiotics) as a means of treating or preventing infant and child allergies. from reviews, there appears to be a treatment benefit for eczema, but not asthma, wheezing or rhinoconjunctivitis. several reviews concluded that the evidence is sufficient for it to be recommended in clinical practice.