Reintroducing milk into your child’s diet

0

Many children with milk allergy will outgrow their allergy by the time they are 3 to 5 years old. Most children who have symptoms such as colic, reflux, eczema and diarrhoea as a baby, or young child, will start to outgrow this earlier in life, from about 9-12 months of age.

Although most children will outgrow their allergy there is still a small possibility that your child will react to some milk-containing food. To try to keep any reactions as mild as possible, some planning is required. When to try reintroducing milk:

    •   Retry milk when your child is otherwise well.
    •   Have some antihistamine (eg Piriton® or cetirizine) available.
    •   Do not retry milk for the first time when you are very busy or have an important appointment to go to!

We have divided milk-containing foods into 5 groups, in approximate order of how well tolerated they are (see table – this is sometimes called a ‘Milk Ladder’)

‘The Milk Ladder’

Group 1
Manufactured/highly processed foods containing highly cooked cow’s milk Malted milk biscuits
Digestive /Garibaldi biscuits
(check the labels that they actually have milk)
Home-made recipes available- ask your dietitian

Group 2
Cooked homemade food where small amounts of cow’s milk is present Scones, cakes, fruit crumble, Scotch pancakes, Shepherd’s pie
Cooked products using standard sunflower margarines containing cow’s milk proteins may be tolerated before similar quantities of butter

Group 3
Dairy products
Yogurt, cheese, butter, fromage frais Sunflower margarines containing cow’s milk proteins may be tolerated before similar quantities of butter.

Group 4
Homemade foods containing large amounts of cow’s milk
Rice pudding, Yorkshire puddings, pancakes, white sauce.
Foods cooked with dried reconstituted milk or sterilised milk may be tolerated earlier than using standard milk.

Group 5
Cow’s milk- sterilised milk may be tolerated earlier
Start with 1 tablespoon or on cereal Increase amount of cow’s milk Some children will tolerate goat’s or sheep’s milk before cow’s milk

If having less than 400mls of cow’s milk, you will still need a milk substitute with added calcium

How to try the milk-containing food:

  •   Try a very small amount of the food first (e.g. pea-size piece of biscuit) and wait for 15-30 minutes before giving your child a second slightly larger portion. Only try a small amount the first day and then try a larger portion the following day. You can then gradually increase to a normal portion.
  •   If a highly cooked food is tolerated try other foods from group 1 and continue with this group for about 3 months. You do not need to be as cautious when trying other new foods from these groups but still always have antihistamine available. Following this you can try group 2 starting with foods made with sunflower margarines which contain some milk.
  •   You can then try foods from the dairy products group e.g. 1⁄4 teaspoon yoghurt or a tiny piece of cheese. As before wait 15-30 minutes before giving your child a second slightly larger portion. Try a larger portion the following day or later that week. Then try other dairy foods from group 3.
  •   Group 4 are cooked foods where milk is a major ingredient. Some children tolerate these before tolerating yoghurt, cheese etc., so you may wish to try these even if there have been minor reactions to group 3. (i.e. mild rashes, tummy ache – not if reactions have been more severe to other groups during reintroduction
  •   Wait at least 6 months continuing with cooked milk and dairy products without any reactions before trying any plain uncooked milk starting with very small quantities. (For children who have only had symptoms of colic, reflux or diarrhoea it is usually possible to do this faster).

 

Source:Royal United Hospital Bath NHS.

Share.

About Author

Rachel

Mum of three and co-founder of reflux sites - refluxSUPPORT, babyREFLUX and littleREFLUXERS.Gathered loads of experience and wisdom talking to thousands of mums and dads who have little refluxers. Campaigning to reduce the number of infants given prescribed drugs for reflux.Superb at parallel parking and eating biscuits.