How do I start the milk ladder for my baby with Cow Milk Protein Allergy (CMPA)?
The milk ladder is a structured approach to reintroducing dairy, starting with small, baked quantities and gradually increasing as tolerated. Begin with step one (e.g., homemade cookies made with a small amount of milk), starting with about 1/4 to 1/2 of a serving once a day. If no symptoms appear after 3–5 days, you can slowly increase the frequency or quantity. Always monitor for reactions like rashes, vomiting, mucus or blood in stools, or fever, and if symptoms occur, pause the ladder, allow the gut to heal for at least two weeks, and restart from the previous tolerated step once the child is symptom-free.
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