This information leaflet is for guidance only and to be used by parents/guardians, wishing to carry out a Milk Challenge on their child at home with the advice of your doctor / dietitian.

It is only a guide to support advice from your doctor or dietitian which must be obtained prior to considering a milk challenge.

The North West Paediatric Allergy Network accept no responsibility for allergic reactions that occur as a consequence these home challenges.

Before starting the challenge

  • Ensure your child is well. If your child has had a flare up of their eczema, asthma, hay fever, or has taken antihistamines in the last five days do not undertake the challenge.
  • Do not attempt this challenge if your child has ever had any breathing problems or faintness/floppiness after having milk. Seek medical advice.
  • Have a supply of antihistamine, for example, piriton available in case a reaction occurs.
  • Pick a day when you will be able to observe your child for at least four hours.

Key things to note

  • Some children are often fearful (as are their parents) of taking foods that have previously caused a reaction. If your child is old enough, try to explain why the challenge is being done.
  • Some challenges may only get part way through the stages and a reaction occurs. If this happens and there are no breathing problems or faintness, try reintroducing the food again in 6 to 12 months.

Stop the challenge if any of the following develop

  • Red, raised, itchy rash
  • Swelling to where the food has been applied
  • Vomiting/tummy pain/loose stools
  • Difficulty/noisy breathing
  • Wheeze/persistent cough
  • Dizziness/feeling faint/floppiness

Give your child antihistamine if a rash or swelling develops. Symptoms should resolve within half an hour. In the very unlikely event of breathing problems or faintness, please take your child to the nearest Accident & Emergency Department. Do not rechallenge, but seek medical advice.

Challenge

  1. Give the child a drop of milk. (Dip a clean finger in milk, shake off the excess and then touch your child’s tongue with the finger).

       Wait 15 minutes, if no reaction occurs continue.

 

  1. Give your child ¼ of a teaspoon (1.25ml) of milk.

Wait 15 minutes, if no reaction occurs continue.

 

  1. Give your child half a teaspoon (2.5ml) of milk.

Wait 15 minutes, if no reaction occurs continue.

 

  1. Give your child a teaspoon (5ml) of milk.

Wait 15 minutes, if no reaction occurs continue.

 

  1. Double this amount every 15 minutes if no reaction occurs, until a cup (200ml) of milk has been taken, provided this does not exceed their normal intake volume. If your child does get any symptoms detailed previously at any stage, stop the challenge and give a dose of antihistamine.

If no reaction occurs over the next two hours, you can introduce milk back into to your child’s diet. If a reaction does occur, continue with a dairy free diet and try challenging with milk again in 6 to 12 months.