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Allergy: Food Challenge for Extensively Heated Milk (HMFC) (513)

Allergy: Food Challenge for Extensively Heated Milk (HMFC) (513) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Nutrition


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:
ξ 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)
ξ 1/3 cup vegetable oil
ξ 3 large eggs or egg-substitute equal to 3 eggs
Pan size/bake time:
ξ 13 x 9-inch: 32-35 minutes or
ξ 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.
If your child is allergic to eggs and you need an egg-substitute for this recipe, here are a few
ξ Ener-G® Foods Egg Replacer: http://www.ener-g.com/egg-replacer.html
ξ Silken Tofu: substitute ¼ cup of whipped silken tofu for each egg
ξ Flaxseed: Blend 1 teaspoon flaxseed powder with ¼ cup of water for each egg
ξ Pureed fruit (mashed banana, applesauce, pureed prunes): ¼ cup for each egg (cooking
time may be longer)

Pediatric Allergy Clinic 608-263-6180

Teach Back

What is the most important thing you learned from this handout?

What changes will you make in your diet/lifestyle, based on what you learned today?

If you are a UW Health patient and have more questions please contact UW Health at one of the
phone numbers listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s
Hospital (AFCH) can be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770.

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 9/2017. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Clinical Nutrition Services Department and the Department
of Nursing. HF#513