Milk ladder handhold

[CakeRage]

DS was diagnosed with multiple severe allergies as a baby, most of which he’s slowly grown or is growing out of.

He’s now nearly 7, and after his milk IgE level dropping to 0.1 and passing a baked milk challenge in hospital, we’ve been given the go ahead to try the rest of the milk ladder at home.

He’s been doing really well, and we are now up to scotch pancakes with no sign of reaction, which we’re all really happy about. But the ladder we’re following from the dietician only has 6 steps, and the next one is cheese. It seems like such a huge leap from pancakes and I’m fretting!

I don’t know why I’m so hung up on this one particular step. Has anyone been through this and can tell me I’m being ridiculous over nothing?

[Teddyreddy]

My daughter is a non ige allergy but we switched to use the older 13 step map milk ladder instead of the new 6 step imap one. The main reason we swapped was that like you I found pancake to uncooked cheese too big a jump. The extra steps on the map milk ladder are shepherd's pie baked with milk in the mash (we did several goes at this with increasing amounts of milk in the mash), lasagna baked with a white cheese sauce (ie quite a bit of milk / cheese but baked for at least 30 min and then pizza (so cheese only cooked for 10 or 15 min). If you'd rather take it more slowly googling 'map milk ladder' will find you the ladder.

[Tournesol]

That sounds like a massive leap. I've been up the milk ladder multiple times with my 9yo but never made it past half a muffin as his asthma always gets horrendous by that point.
Maybe Google around for a more gradual ladder? Pretty sure they're only meant to have very tiny amounts of well cooked dairy, so a sprinkle of melted cheese in a scone rather than a whole hunk of cheese? Can you ask to speak to a dietician?

[CakeRage]

This has come directly from his dietician! We saw her last week and talked it all through. I did ask her about a more gradual ladder, as that was what our trust used to follow when he was first diagnosed, but she said that they’ve decided to follow the 6 steps instead as it is simpler for parents to follow and it didn’t seem to affect outcomes. She also said that theoretically home made scotch pancakes would be on a similar level to shepherds pie/lasagna, as the milk is cooked at a high temperature but for a very short time, while the others are cooked at a high temperature for a long time, but the insides may not reach the max temperature, so would effectively be cooked at a moderate temperate for a long time. She seems to know her stuff, and she’s been brilliant with us so have no reason not to believe her, but it just makes me panic when I think about it!

She advised to first give a tiny square of cheese on toast when we move to the next step rather than handing him a giant block of uncooked cheddar, but there’s something about the oozy cheesiness which makes me brain think it’s high risk

[CakeRage]

God, excuse spellings. I’m on my phone.