Milk Ladder Update

Four weeks ago I was feeling terrified at the prospect of starting the milk ladder. How would we get on? Would Millie react on day one? What if her reactions were serious? What if my baby got ill? So many concerns, but I knew we had to give it a go sooner rather than later.

I posted at the beginning of our journey and promised to keep you updated along the way, so here is our latest update, unfortunately it wasn’t meant to be this time around, but it didn’t stop her smiling:

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– Week 1 Malted  Milk biscuits – we used Tesco own brand malted milk biscuits and Millie couldn’t get enough of them. Day one and I was so relieved we didn’t have any immediate reactions, no vomiting or diarrhoea, no swollen tummy. In fact it wasn’t until day five that I noticed a few small patches of eczema starting to form on the back of Millie’s legs. She hasn’t ever suffered from eczema so naturally I put it down to the milk ladder.  As it was so minor we decided to keep going.

– Week 2 Garabaldi Buscuits – again I used Tesco own brand biscuits. I was beginning to get a bit concerned about the amount of sugar Millie was consuming on the milk ladder so decided for future stages I would make my own of everything rather than use shop bought. After a couple days on step 2 Millie started to dribble a lot more than normal, this had always been a sign of a bad reflux day in the past so I began to wonder if it was milk related and it had triggered a relapse in her reflux. I decided to see out the week and monitor if it got any worse. It didn’t seem to change at all for the next few days so we moved on.

– Week 3 Mini muffin – despite vowing to bake my own I again went for shop bought, partly because I was beginning to think Millie would fail at this step so would just buy a few cakes as we probably wouldn’t need them anyway. Across the week Millie continue to dribble quite severely and also started grinding her teeth both day and night. I couldn’t figure out if this was perhaps teething related despite her having all 8 front teeth now or if it was in fact an allergy. We finished week 3 with no real change in the symptoms.

– Week 4 Scotch Pancakes – the instructions indicate giving a full pancake but this seemed an awful lot to give a baby so I just went for half a pancake. Within just a few hours Millie’s tummy became extremely swollen, she continued to dribble excessively and she now had really dark rings under her eyes. Although showing some signs of a reaction they didn’t seem quite severe enough to give up so we tried day two of the scotch pancake. The dribble was horrendous for the rest of the day, having to change bibs every 20 minutes. That night she was grinding her teeth so badly during the night that she made her gums bleed and absolutely covered her bed in blood. My mum had previously told me that teeth grinding can be a sign of an allergic reaction, it is a way of diverting the pain or irritation caused by the allergy (being an allergy kid myself my own mum is also pretty hot on all things allergy related) but for some reason I brushed it off. However seeing blood all over the bed that night really upset me and I realised my tough little cookie was in fact suffering in her own quiet way and I’d probably pushed the milk trial as far as I should!

So we got as far as day two of step four! I did feel a little disappointed that we weren’t able to get further this time but seeing my baby suffer I knew it was time to stop, for now.

Having now made our first stab at the milk ladder I’ve definitely learned a few things about the process so far:

– it’s not as scary as it seems – having made it through week one I do feel a little more confident to continue and realise that it is a really slow approach to the reintroduction of dairy and you can take it as slow as you need to.

– you know your own child and when the time is right to stop.

– teeth grinding really is a symptom of allergies. Sorry mum I should have learnt by now you really do know best!

– my little girl really is a toughie – when Millie’s reflux was at its most severe our health visitor told us that she will probably turn out to have a very high pain threshold as she has spent most of her early months hurting from reflux that she will become used to feeling pain. This has proved true so far with both teething and also how she coped when she was obviously feeling discomfort during the milk trial.

We are now having 4-6 weeks of dairy free time before we even think about starting again. I don’t feel in any hurry to give it another go and want to make sure Millie is completely over her symptoms first.

 

Overcoming our fears as we start the milk ladder

If you are following the blog you will have seen in a few previous posts that Millie, now almost 11 months old, has a dairy allergy (cows milk protein allergy, CMPA for short) along with a couple of other food allergies. It has meant that the weaning process has been both restrictive and quite complex, slowly trying new foods to make sure there are no other allergies. So far we know she has CMPA, soya and possibly a cod allergy.

As she’s approaching her first birthday and will be starting nursery in a few weeks I have decided to start her on the milk ladder, giving us a couple of weeks at home to take the first few steps with her. The milk ladder is a way of challenging and reintroducing dairy very slowly into an allergy sufferers diet. Each step of the ladder trials milk in different forms, starting with cooked milk leading right up to rung 12 which is tolerating milk in its pure form to drink.

Below is a link to the milk ladder we have been given to follow, there are other alternatives around, some of which differ greatly but offer more flexibility at each stage.  I may look into using a different ladder further along the way as I’m not particularly keen on giving Millie shepherds pie every day for a full week!

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We had an appointment with a dietician a few months ago to talk through the process and to get all of the relevant information we needed. Quite frankly the appointment was a waste of time! Since then I have done a lot of reading about how to go about a milk challenge and the best ways of following the milk ladder. But for some reason I have still been feeling incredibly nervous! Im guessing its quite common to feel this was as its a fear of the unknown, wondering what symptoms or reactions your baby will have, not wanting to cause them any pain, worrying that they will fail the challenge! So I thought I’d write a list of some of the really valuable advice I’ve read and things to remember along the way:

– Take all the time you need – although the recommendations are to try each step for a week and if no reaction move on to the next step, if you don’t feel ready or are unsure if there has been a reaction then there is no need to move on just because the week is up. My health visitor suggested to try each step for two weeks initially for Millie as she had only ever been exposed to dairy through breast milk so we were unsure of her reaction symptoms.

– Talk to others who are also starting the ladder – this has been crucial for me. I think because we didn’t have a very positive experience with our dietician I have called upon various support groups whenever I have had a question. I also regularly look through previous posts in the groups as there is more than likely someone out there who has already asked the exact same question that is worrying you. (this group on facebook has been invaluable for us CMPA Support For Weaning)

– Familiarise yourself with possible signs of a reaction – for us Millie’s reactions had always been fairly sudden and severe vomiting, explosive nappies and a swollen tummy. It wasn’t until I started reading a bit more that I discovered things like puffy eyes, coughing and wheezing, dark circles under their eyes, constipation and even blood in their stools can be a sign of a reaction. Because these had never happened to us I wouldn’t have know to watch out for them.

– Make others aware – this may seem obvious but in our case I intend to fully brief Millie’s nursery of the stage we are at on the ladder before she starts and also give them full details of things to look out for in case she starts showing a reaction while she is in their care. Thankfully it doesn’t seem like Millie has any IgE reactions to cows milk (things such as breathing difficulties, swelling of the lips and tongue, loss of consciousness etc) but I still think it’s crucial to keep updated anyone who is caring for your child as you never know how well aware they are of allergies.

– Be prepared – if you plan to cook everything for each stage of the ladder yourself make sure you have all of the recipes to hand ready for moving on. Alternatively if you are using shop bought products make sure to check the ingredients to ensure they include the right form of diary ie malted milk biscuits for stage 1 should include milk powder not whey powder.

– Don’t panic – if your little one does react the best advice I have been given is to not panic. You need to stop all dairy for at least a month, or longer if symptoms still haven’t cleared, and then restart again from stage 1.  Some children take a good few years to grow out of their allergies and only a few manage to complete the ladder first time round.

We are now on day five of stage 1, Millie has been eating a full malted milk biscuit everyday for five days without any severe reactions but I will do a full update at the end of each week which will also include any recipes we have used.

Surprisingly dairy and soya free!

When Millie was diagnosed with a dairy and soya protein allergy I was still breastfeeding. Determined to continue, I cut dairy and soya completely from my diet. It wasn’t until I started reading every ingredient label on every last thing I bought that I realised just how many day to day products have either dairy or soya in them. Who would’ve thought gravy granules were a no go or sliced white bread??!!

There were however a few surprises out there that I was convinced couldn’t possibly be dairy and soya free but were in fact “safe foods”. So here is my list of unexpected dairy and soya free every day products that you can pick up in most supermarkets without having to go anywhere near the free from aisle:

1. Oreos – this is by far the most surprising of all. I really missed milk chocolate and when I was really craving a bar of dairy milk I would have a couple of Oreos to get my chocolate fix.

2. Puff pastry – jus-rol and tesco own brand are both soya and dairy free and there is so much you can make with it. Millie loves both sweet and savoury pinwheels and mini vegetable pasties.

3. Crumpets – when I found out I could no longer have white bread I thought everything pastry/bread-like would also be a no go but most brands of crumpets are safe just remember to use a free from spread not butter!

4. Tesco value celebration cake – it was my birthday in July and the thought of not being able to have a slice of cake made me a little sad but a quick scour of the cake aisle in tesco and I discovered their basic celebration cake was both dairy and soya free and great for any celebration not just birthdays.

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5. Mayonnaise – I automatically thought Mayo would contain some form of dairy so started buying one from the free from aisle rather than Helmans but on closer inspection Helmans Real Mayonaise is in fact fine to have. Unfortunately the low fat versions are made with cream so aren’t  dairy free which is slightly annoying.

6. Drinking chocolate – most hot chocolates such as options, cadburys and galaxy are all made with milk but if you buy every day drinking chocolate and make it with your choice of alternative milk instead of water it is just as nice!

7. Bagels – just like crumpets most bagel varieties are dairy and soya free and a great alternative to bread for a sandwich.

8. Basic digestive biscuits – it seems that the cheaper brands of digestive biscuits are safe but unfortunately not McVities which is a shame as they are my favourite!

All of the above were free from soya and dairy at the time of writing but please check before buying just in case the recipes have changed which does seem to happen sometimes.

Quick and easy dairy-free snacks -3 super simple baby led weaning recipes

At just six weeks old Millie was diagnosed with cows milk protein and soya protein allergies. Despite her restrictive diet I was still determined to go down the baby led weaning (BLW) route which has at times been rather challenging and has made me rethink a lot of the meals we eat as a family.

The point of BLW is to allow your baby to eat what you’re eating and make their own choices about what they want to eat and how much. This has been a real nightmare for us with a very fussy ten year old and an equally fussy husband, our family meal repetoire is already somewhat limited. I have over the last few months trialed, tested and on some occasions binned many dairy free recipes in the hope of finding meals we can all eat as a family.

Lunch time snacks have proved to be the hardest meal for us to get any variety. Millie loves bread, and I mean REALLY loves it. She would have a dairy free cheese sandwich for every meal if she could. But I wanted to find some non-bread alternatives that fit the following criteria; quick and easy to make, high in calcium (it can be really hard to hit a baby’s calcium target on a dairy free diet), and finally they needed to be “portable” so they could be packed for lunch on the days we were out and about at baby classes.

Here are our top three favourites:

1. Pastry Pinwheels – these are so versatile and can be batch cooked and frozen.

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Using ready to roll puff pastry sheets cut into inch wide strips (Most puff pastry is dairy and soya free including shop own brands but we use Tesco’s own puff pastry sheets which can be found in the fridge next to the margarine and butter). Spread your choice of filling onto the strips of pastry and loosely roll into wheel shapes. Bake in a pre-heated oven for 15-20 minutes at 180C until golden.

One of Millie’s favourite fillings is a pouch of Ella’s Kitchen purée (roast pork and apple sauce used in the picture above) and sprinkled with dairy free cheese. These turn out like really yummy baby (and mummy… Eek!) friendly pasties!

2. Fish Pate – great on rice cakes or toast.

At 9 months old Millie is yet to develop a liking of fish and she will simply spit it straight back out of it ever gets even close to her mouth. I was keen to find a way of adding fish to her diet in a way that wasn’t too “fishy”. This pate was perfect! It uses all dairy free alternative ingredients but can of course be made in exactly the same way with normal dairy products.

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Ingredients:

150g of cooked salmon or any other fish (I use cod)

150g of soft dairy free cheese

Juice from half a lemon

2tbsp of natural dairy free yoghurt (I use coconut milk yoghurt as we are also soya free)

Chuck all the ingredients into a blender and mix until smooth.

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I have also added this to cooked pasta with some veg to make an alternative pasta sauce.

3. Cheesy Egg Muffins – perfect for packed lunches

These egg muffins again can be adapted to include any other cooked ingredients you like. For these ones I just added some chopped tomatoes.

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Whisk two large eggs and a dash of milk in a bowl (we use Oatly oat milk). Add in 30g of grated dairy free cheese and any cooked ingredients such as chicken, other vegetables or fish. Split the mixture across 4 or 5 muffin tins and bake in the oven for 15 minutes on 180C.

These are so simple to make and can be eaten either hot or cold. They have become a particular favourite in the post swimming packed lunch box each week!

I have tested out quite a few other dairy and soya free meals including some family favourites which I will include in future posts. Making things from scratch is one of the most reliable ways of ensuring your childs meals only include “safe” foods. Despite being a little tricky at times, I am enjoying cooking fresh, nutritious, dairy free meals for Millie and love watching her devour them without any sign of a reaction!