Understanding Food Challenges and the Milk Ladder

Once your child’s allergy is stable, you may be wondering: when will they grow out of it?

This is where food challenges like the milk ladder come in.

What Is a Food Challenge?

A food challenge is the gold-standard test for confirming whether your child is still allergic to a certain food. It involves giving small, carefully measured amounts of the food under supervision (sometimes in a hospital setting) and watching for any reaction.

What Is the Milk Ladder?

For children with non-IgE mediated (delayed) milk allergy, the milk ladder is a structured, home-based way to reintroduce milk in stages- starting with foods where milk is baked into the recipe (like a muffin), and slowly progressing toward fresh milk.

Each step introduces milk in a slightly less cooked or processed form, which helps the immune system re-learn to tolerate it gradually. The typical order moves through:

1. Fully cooked milk in a flour matrix (pancakes, muffins, biscuits)

2. Cheese

3. Yogurt

4. Fresh milk

Your dietitian will guide you on when to begin, how to monitor reactions, and when to pause or progress on the ladder.

Read more in ‘what is a milk ladder challenge’

Need Extra Support?

If you’d like one-to-one guidance through an allergy diagnosis, reintroduction, or allergy-safe weaning, I offer personalised consultations to help you feel informed, and supported through every stage of your child’s allergy journey.

👉 Book a session or explore more resources in the Milk Allergy Hub.