Navigating Infant Milk Allergy with the Indian Milk Ladder

By - Danone Nutricia Academy

Danone Nutricia Academy

Cow’s milk protein allergy (CMPA) is a common condition in infants, often appearing within the first few months of life. It occurs when the immune system mistakenly identifies proteins in cow’s milk as harmful, triggering allergic reactions. In India, managing CMPA effectively requires approaches that align with local dietary habits and cultural practices ¹

Diagnosing CMPA involves reviewing the infant's medical history, physical examination, and specific allergy tests like skin prick tests or serum-specific IgE tests. Symptoms can range from mild skin rashes and gastrointestinal discomfort to severe reactions like anaphylaxis2. Accurate diagnosis is crucial to avoid unnecessary dietary restrictions that could impact the infant’s growth and nutrition ³

Traditionally, managing CMPA means completely eliminating cow’s milk from the infant’s diet. This approach, while effective, can be challenging for families and may lead to nutritional deficiencies if not carefully managed.

The Indian Milk Ladder is a culturally tailored tool designed to help families gradually reintroduce milk into the diets of milk-allergic infants. Developed through expert consensus and validated for milk protein content, this tool aligns with Indian culinary practices, making it practical and accessible for Indian families ¹

Using the Indian Milk Ladder involves a structured, step-by-step process. Parents start by introducing foods that contain extensively heated milk proteins, such as baked goods, which are less likely to cause an allergic reaction. As the child tolerates each stage, parents can gradually introduce less processed milk products. This gradual exposure helps build the child’s tolerance to milk over time, reducing the risk of severe allergic reactions.

The Indian Milk Ladder is a valuable tool for Indian families dealing with CMPA. By incorporating familiar foods and cooking methods, it helps children with CMPA gradually adapt to milk, improving their quality of life and dietary diversity. This home-based management approach also reduces the need for frequent hospital visits, making the process less stressful for both the child and the family ¹

References

Ramakrishna SH, Shah N, Acharyya BC, et al. The Need for Culturally Appropriate Food Allergy Management Strategies: The Indian Milk Ladder. Nutrients. 2023;15(18):3921. doi:10.3390/nu15183921.
Venter C, Brown T, Shah N, et al. Diagnosis and management of non-IgE-mediated cow's milk allergy in infancy - a UK primary care practical guide. Clin Transl Allergy. 2013;3(1):23. doi:10.1186/2045-7022-3-23.
Fiocchi A, Brozek J, Schünemann H, et al. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines. Pediatr Allergy Immunol. 2010;21(Suppl 21):1-125. doi:10.1111/j.1399-3038.2010.00923.x.