Additional File 4 iMAP Milk Ladder Recipes

STEP 1: COOKIE OR BISCUIT – SWEET/PLAIN

Milk
tsp/tbsp/ Milk per
Recipe g/ml oz/lb Ingredient protein per Temperature
cup portion (ml)
portion
1 cookie/biscuit 1 ml 0.35 g
Flour
1 cup 125 g 4.5 oz
(wheat or wheat free)
Xanthan gum – if 180⁰C or 350⁰F
¼ teaspoon 1g wheat free flour is Bake for 10 – 15 min
used Depending on size of
¼ cup 50 g 1 ¾ oz Cold dairy free spread cookie/biscuit
Bakes 20 small finger size
biscuits/cookies ¼-⅓ cup Practical tip – let dough
(may vary Grated apple/pear/ cool in fridge for 30 min
depending on pureed banana – which makes it easier
fruit) handle
Skimmed/non-fat milk
1 teaspoon 2g
powder*
Tip of a knife Vanilla powder

1. Mix the flour, xanthan gum and milk powder

2. Rub in the cold dairy free spread
3. Mix in the fruit (you may need to add a little bit more if it is too dry) and vanilla powder
4. Roll out and cut in finger sized strips
5. Bake in the oven
Start with 1 cookie/biscuit (equivalent to 1 ml of milk); increase to 2 and then
3 cookies/biscuits (equivalent to 3 ml of milk - if child can manage a portion of 3 3 ml 0.105 g 180⁰C or 350⁰F
biscuits/cookies)
STEP 1: COOKIE OR BISCUIT – SAVOURY

Milk per Milk

tsp/tbsp/
Recipe g/ml oz/lb Ingredient portion protein per Temperature
cup
(ml) portion
1 cookie/biscuit 1 ml 0.035g
Flour
1 cup 125 g 4 ½ oz
(wheat or wheat free) 180⁰C or 350⁰F
Xanthan gum – if Bake for
¼ teaspoon 1g wheat free flour is 10 – 15 min
used depending on size of
Bakes 20 small finger size cookie/biscuit
¼ cup 50 g 1 ¾ oz Cold dairy free spread
biscuits/cookies
Grated DAIRY FREE Practical tip – let dough
⅓ cup 40 g 1 ¼ oz cool in fridge for 30 min –
CHEESE
Skimmed/non-fat milk which makes it easier
1 2g handle
powder*
teaspoon
2
10 ml Water
tablespoons
1. Mix the flour, xanthan gum and milk powder
2. Rub in the cold dairy free spread
3. Mix in the grated DAIRY FREE CHEESE. Add water (you can add a bit more if it is too dry)
4. Roll out and cut in finger sized strips
5. Bake in the oven
Start with 1 cookie/biscuit (equivalent to 1 ml of milk); increase to 2 and then
3 cookies/biscuits (equivalent to 3 mls of milk - if child can manage a portion of 3 3 ml 0.105 g 180⁰C or 350⁰F
biscuits/cookies)
 STEP 2: MUFFIN – SWEET/PLAIN

Milk
tsp/tbsp/ g/ml oz/lb Milk per
Recipe Ingredient protein per Temperature
cup portion (ml)
portion
Start with half a muffin and then one muffin: half a muffin 12.5 ml 0.0.875 g
: one muffin 25 ml 0.875 g
Flour
2 cups 250 g 8 oz
(wheat or wheat free)
Xanthan Gum – if wheat
½ tsp 3g free flour is used 180⁰C - 200⁰C
or
2 ½ tsp 10 g 1/3 oz Baking powder
350⁰F- 400⁰F
Sugar – if your child is
2 level
25 g 2/3 oz older you can add 2-3 Bake for 15 – 20 mins
tbsp
tablespoons Tip – use a whisk and milk
Bakes 6 muffins
and oil together. This
Pinch Salt
makes the muffins light
1 2/3 Sunflower oil
¼ cup 50 ml
fl oz or Canola oil
1 cup 250 ml 8 fl oz Milk**
Finely chopped/mashed
½ cup
110 g 3.9 oz fruit: apple/pear/banana
and
1 tbsp

Vanilla essence to taste

1. Mix flour, xanthan gum, baking powder, sugar and salt
2. Mix oil and milk together and to the dry ingredients
3. Finally add in chopped fruit and vanilla (additional) and mix through
4. Bake in oven
1.5 muffin = equivalent to baked milk muffin from Mount Sinai Recipe(1) (which contains 1.3 g milk)
STEP 2: MUFFIN – SAVOURY

Milk
Recipe tsp/tbsp/ g/ml oz/lb Ingredient Milk per protein Temperature
cup portion (ml) per
portion
Start with half a muffin and then one muffin: half a muffin 12.5 ml 0.0.875 g
: one muffin 25 ml 0.875 g
Flour
2 cups 250 g 8 oz
(wheat or wheat free) 180⁰C - 200⁰C
½ Xanthan Gum – if or
3g
teaspoon wheat free flour is 350⁰F- 400⁰F
used
Bake for 15 – 20
Bakes 6 muffins
2 ½ tsp 10 g 1/3 oz Baking powder mins
Tip – use a whisk
Pinch Salt
and milk and oil
1 2/3 Sunflower oil or together. This
¼ cup 50 ml
fl oz Canola oil makes the muffins
1 cup 250 ml 8 fl oz Milk ** light
Grated DAIRY FREE
½ cup 60 g 2 oz
CHEESE
1. Mix flour, xanthan gum, baking powder and salt
2. Mix oil and milk together and to the dry ingredients
3. Add DAIRY FREE CHEESE; Add a bit of water if required - Feel free to chop in a handful of spinach to add colour and fibre
4. Bake in oven
1.5 muffin = equivalent to baked milk muffin from Mount Sinai Hospital(1) (which contains 1.3 g milk)
 Step 3: PANCAKE

Milk
tsp/tbsp/ Milk per
Recipe g/ml oz/lb Ingredient protein per Temperature
cup portion (ml)
portion
Start with half pancake and then 1 pancake as indicated below: half a pancake 21 ml 0.735 g
: one pancake 42 ml 1.47 g
Flour (wheat or wheat
1 cup 125 g 4.5 oz
free)
2 ½ tsp 10 g 1/3 oz Baking powder
Fry in a hot pan using oil
¼ tsp 1-2 g pinch Salt
Bakes 6 pancakes of choice until golden
Sunflower brown and crispy
2 tbsp 30 ml 1 fl oz
or Canola oil
1 cup 250 ml 8 fl oz Milk**

2/3 cup 50 ml 1.5 fl oz Water

1. Add all ingredients into a mixing bowl and mix together
2. Fry in a hot pan
Some children do not like cake or pancake textures: For these children there is the option of boiling a small potato, adding 42 ml of milk
(1.3 g protein) and some milk free spread, cover with foil and bake in the oven for 40 minutes at 180⁰C - 200⁰C
or 350⁰F- 400⁰F. This product does not contain any wheat in the food matrix and it may therefore affect the allergenicity.
 Step 4: CHEESE

Milk Milk
Food tsp/tbsp/ g/ml oz/lb Ingredient Temperature
per portion protein per
cup
(ml) portion
85⁰C or 185⁰F (no need
Cheese 2 ½ tbsp 15 g ½ oz Cheese*** 15 g 3.43 g to further heat this – just
an indication of how
cheese is made)

Step 5: YOGHURT

Milk Milk
Food tsp/tbsp/ g/ml oz/lb Ingredient Temperature
per portion protein per
cup
(ml) portion
98⁰C (no need to further
6.0 g heat this – just an
Yoghurt ½ cup 125 ml 4.5 fl oz Yoghurt 125 ml depending indication of how
on brand yoghurt is made)
Once your child tolerates yoghurt, butter, spread, chocolate buttons, fromage frais, petit filous (be careful of the sugar content),
you can introduce softer cheese like cream cheese and camembert/brie – remember to use pasteurised soft cheese for children

Step 6: MILK

Milk Milk
Food tsp/tbsp/ g/ml oz/lb Ingredient protein per Temperature
per portion
cup portion
(ml)
57-68⁰C
⅖ cup 100 ml 3.5 fl oz 100 ml 3.47 g 15-20 seconds
Both pasteurised milk
Protein information obtained from: https://ndb.nal.usda.gov/ndb/search/list

* The protein content of milk powder was calcul ated using: Basic Report: 01091, Milk, dry, non-fat, regular, without added
vitamin A and vitamin D
** The protein content of milk was calculated using: Basic Report: 01085, Milk, non-fat, fluid, with added vitamin A and vitamin D
(fat-free or skim)
To convert g of milk to ml of milk a conversi on of 1.031 was used i.e. 1 g milk = 103.1 g = 100 ml
*** The protein content of cheese was calculated using: Basic Report: 01009, Cheese, cheddar

1. Leonard SA, Nowak-Wegrzyn AH. Baked Milk and Egg Diets for Milk and Egg Allergy Management. Immunol Allergy Clin North Am.
2016;36(1):147-59.

Pasteurised Milk Pasteurised Milk** and infant formula is

¾ cup 200 ml 7 fl oz 200 ml 6.95 g produced this way –
there is no need to
further heat this.