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Introduction

  • Before commencing the challenge, your child should be well. This means their eczema, asthma or hay fever is well controlled, the do not have a cough, cold, diarrhoea or vomiting. If they have started a new medication, wait for two weeks to ensure they tolerate it before introducing milk.
  • Do not give your child any antihistamines before or during the challenge days unless a reaction occurs, as these may hide or delay reactions. If your child has used their reliever inhaler such as salbutamol or terbutaline in the last 3 days, delay the introduction

Continue to give your child any other medication that they usually take.

  • Do not to introduce any other new foods while introducing milk into the diet.
  • Introduce one of the foods as outlined in table opposite. Try to give the recommended challenge food in one go rather than spreading it out over the day.

Choose a time of day when you are able to monitor/observe your child closely. If an immediate reaction occurs stop the challenge and seek advice. Delayed symptoms may occur up to 3 days after the challenge, stop the challenge at the stage which is tolerated and try again in 4-6 weeks. Keep the tolerated foods in the diet and give regularly. 

Stage 1

A food that has milk within the ingredients list e.g. biscuit or food containing butter, margarine or whey

Give this food once a day for three days, if no symptoms keep in the diet in addition try other foods that are

similar e.g. cake, malted milk biscuit, milk roll bread

Stage 2

Normal butter or margarine e.g. in mashed potato, on toast, stirred into vegetables

For three days give once a day and then increase to twice a day if no symptoms.

Stage 3

Yoghurt or fromage frais

For three days give 1 teaspoon once a day and gradually increase the amount and then give twice a day if no

symptoms. 

Stage 4

Cooked cheese

For three days give 1 teaspoon of grated cheese cooked on toast or in a jacket potato.

Stage 5

Uncooked cheese

Try 1 teaspoon of grated cheese once a day and gradually increase the quantity and number of servings.

Stage 6

Heated cow’s milk/UHT milk

Try a food with milk that has been heated e.g. cheese sauce, custard, milk pudding.

Stage 7

Cow’s milk

Try fresh cow’s milk on cereal first and then give as a drink.

 

Contact us

If you have any queries relating to this information, please contact the Dietetics service.

About this information

Service:
Dietetics

Reference:
DT/127

Approval date:
1 June 2026

Review date:
1 June 2029

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Important note 

This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.