12-Step Milk Ladder Guide – Parents Should Know

An estimated 53% of infants under the age of 1 have a serious milk allergy problem. That number eventually starts dropping as most kids begin to outgrow it. It may feel scary to some adults but if properly handled, most kids won’t suffer any lasting repercussions from this issue. In this blog, we’re going to talk about the milk ladder, what it is and what recipes you can follow. You can follow a milk ladder approach if your child has a confirmed allergy and after you’ve discussed it with a health professional. 

What is a milk ladder?

A milk ladder is a way to introduce milk to the child’s diet. It is a gradual process, in which the child drinks milk products with different fat content at different times. The milk ladder is mainly used to establish whether your child’s allergies remain or if they have outgrown them. Many kids with cow milk protein allergy will eventually outgrow their reaction to this compound — mostly between the ages of one or three years. 

The milk ladder approach, which in many cases will be introduced by your dietitian or doctor, is a way to test your child’s current reaction to milk. It will allow you to reintroduce cow’s milk into their diet. 

Most kids can start this process between the ages of 9 months and older — you should first consult with your pediatrician. It’s also incredibly important to understand that there is still a small possibility that your child will react negatively to fresh cow milk, or different foods containing the products, as such it is highly recommended that you consider the following precaution before starting a milk allergy ladder:

• Only start the milk ladder plan when your child is healthy. Make sure that they don’t exhibit any rashes, eczemas, tummy aches, fevers, or anything in between. 
• Start once they have had a couple of months without any reaction to dairy products. 
• If your child has had a chest infection or a cold, or any sort of illness, wait a bit before commencing with the milk ladder plan.
• Always try to start the plan in the morning or mid-day, around lunchtime. This ensures that you can monitor your child during the day and take notes on their reaction to milk.
• The milk ladder plan normally stays with foods that are highly processed — it’s important to make sure that your child can tolerate these foods before moving to the next rung.

Also, some kids may not react to processed foods with milk content – say cookies, cakes, biscuits, etc – but get allergic symptoms if you give them fresh cow’s milk. In this case, put a break from the milk ladder process, and talk to your doctor or dietitian. Your child, it’s important to note, isn’t allergic to milk — they are allergic to the proteins in it. When foods are processed, say by heating, these proteins might break up. This means that it won’t trigger your child’s allergies. 

There are two offending proteins:

• Whey Protein.
• Casein.

Your child might not be allergic to both. 

The end goal of a milk ladder plan is to safely introduce dairy products into your child’s diet. Give them the vitamins and minerals those products have in abundance while also liberating you of the stress inherent to carefully planning your child’s meals — trying not to slip up and spark their allergies. 

12-step milk ladder

There are two official milk ladder recipes/processes. 

• The 12-step MAP milk ladder.
• The IMAP 6-step milk ladder.

In this article, we’re going to explain the 12-step program. What’s the main difference? The 6-step program is the newer version, it has condensed certain rungs. Nevertheless, most physicians still prescribe the original. 

But what exactly is the challenge/process?

Well, it’s simple. Each step takes into account a recipe. For example biscuits or pizza. You simply follow a carefully crafted food recipe and feed the result to your child. If they don’t encounter any issues with that food. Then you can move on to the next step.

But what if the step triggers a reaction?

In that case, keep allowing them to have foods from that step and previous ones and wait 3 months until you try to process to the next rung of the milk ladder.

Step 1 — Malted Milk Biscuits

You can either buy malt biscuits or make your own. Homemade biscuits are better since you can avoid other allergens like soy or nuts. These biscuits mostly have powdered milk.

Step 2 — Digestive Biscuits

Make sure you buy biscuits that contain milk during this stage. There are many milk ladder recipes online in case you want to cook them yourself.

Step 3 — Muffins/cupcakes

Most kids that get stuck on the milk ladder challenge normally find their Achilles’ heel in this step. 

Step 4 — Pancakes

Pancakes contain less milk than muffins BUT are baked or cooked for a much shorter time so the allergic proteins are more prevalent.

Step 5 — A portion of Shepherd’s Pie

A child’s bite-size portion of shepherd’s pie loaded with cheese and other dairy products. 

Step 6 — Lasagna

Homemade child’s portion of lasagna. Preferable beef or chicken, not soy.

Step 7 — Cheese Pizza

Preferably pizza that does not contain milk in its base. In other words, don’t buy the cheese-stuffed crust. 

Step 8 — Chocolate

Milk chocolates are high on the ladder not only because they contain dairy, but because they might also contain other allergens. It’s important that during this step you buy good quality processed chocolate. The fewer contaminants it has, the better.

Step 9 — Yogurt

Try introducing them to whole yogurts and see how they react.

Step 10 — Cheese

Most physicians recommend cheddar or gouda during this stage due to their fat content and how much milk they have during production. 

Step 11 —Sterilized Milk Infant Formula

During this stage start with 100ml and carefully increase to 200ml.

Step 12 — Milk

Start with pasteurized infant milk formula and gradually introduce, during this stage, cow’s milk.

How long does the milk ladder challenge take?

It’s important to be incredibly meticulous and take your time during the milk ladder challenge. To allow your kid’s digestive system to get accustomed to new foods, new products, and new tastes. You’re not just introducing dairy, milkshakes, and milk items, but other foods into their body and they need time to acclimate themselves. Each step of the milk ladder challenge takes 1 week. If you don’t encounter any allergic reactions, you should be finished by 12 weeks or 3 months.