Allergy: Food Challenge for Extensively Heated Milk (HMFC)
The goal for a baked milk food challenge is to eat a known quantity of milk in a baked product, such as a cake or muffin. This is usually ¼ cup of baked milk.
If another recipe is used, please bring the recipe to clinic. It is important to use at least 1 cup milk PLUS add 1/3 cup of instant dry milk powder (1/3 cup instant dry milk powder=1 cup of milk, any brand can be used) to the recipe. The baked product is now equal to 2 cups milk and your child will not have to eat as much to get to their goal dose.
For a wheat allergy, use a gluten free mix that calls for 1 cup milk and add the dried milk powder as well.
Prepare for the Food Challenge
1. Do not give antihistamines for the 5 days before the food challenge. The one exception is diphenhydramine (Benadryl®), which can be used up to 24 hrs before the food challenge.
2. Continue to give other allergy and asthma medicines as usual.
3. If your child is sick on the day of the food challenge, call the clinic to reschedule the procedure. Your child needs to be well for a food challenge.
Sample recipe:
Duncan Hines Yellow Cake Mix
You Will Need:
• Replace water with 1 cup MILK PLUS 1/3 CUP DRIED MILK POWDER (helpful hint: mix the powdered milk into the cup of wet milk)
• 1/3 Cup Vegetable Oil
• 3 Large Eggs or Egg-Replacer equivalent
Pan Size/Bake Time:
• 13 x 9-INCH: 32-35 minutes OR
• 24 Cupcakes: 18-21 minutes
1. Prep: PREHEAT oven to 350°F. for metal or glass pans, and 325°F for dark or coated pans. GREASE sides and bottom of each pan. FLOUR lightly. (Use baking cups for cupcakes).
2. Mix: BLEND dry mix, milk, milk powder, oil and eggs (or egg replacer) in large bowl at low speed until moistened (about 30 seconds). BEAT at medium speed for 2 minutes. POUR batter in pans and bake immediately.
3. Bake: BAKE following times listed above. Add 3-5 minutes to bake time for dark or coated pans. Cake is done when toothpick inserted in center comes out clean. COOL in pan on wire rack for 15 minutes. Cool completely before frosting.
4. Cut: 13x9-INCH cake into 12 equal pieces. The “dose” is ¼ cup of milk which is 1½ pieces of cake OR 3 cupcakes (if 24 cupcakes are made).
Please bring 6 pieces of cake or 6 cupcakes to the food challenge.
After Your Child’s Baked Milk Challenge
If your child passed the food challenge for heated milk, wait until the next day to begin giving new foods. After that, he/she may use foods with milk as an ingredient, up to three servings a day. Here is a plan for using baked milk products. You can do this once a day to start or you can progress as slowly as you like to the three daily servings:
• Begin with commercially prepared foods that list milk or a milk product in the last half of the ingredient list. For example, he/she could try bread with milk as an ingredient, or a cracker such as plain goldfish (not cheese goldfish to start). Any “may contain” product would also be fine to use at this point.
• Your child can also use any baked recipe for cookies, cakes, muffins, cupcakes or brownies. Use 1/4 cup of milk for a recipe that makes 12 – 16 servings. He/she can start with one serving.
• If there is no reaction to these products, begin using recipes for baked goods with up to one cup of milk.
• At this stage he/she can also try baked foods with small amounts of cheese, such as cheese goldfish. If these foods are tolerated, your child may eat up to 3 servings daily.
• After three months with these foods, contact us to discuss adding other foods into the diet, such as macaroni and cheese or pizza.
If you have questions about a food that is not listed above or general concerns about what foods to offer, please call the clinic.
Pediatric Allergy Clinic 608-263-6180
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/14/2012
Copyright © 04/17/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#513
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