As I discussed in my last post (“She Passed Her Baked Milk Challenge! What’s Next?”), our family had a huge victory last month when our four-year-old daughter Z finally passed a supervised baked milk food allergy challenge at her allergist’s office (after two previous fails several years ago). Big win! And she’s had no reactions to her dosing so far, though we keep checking—not a hive in sight.
But since then, we have been struggling to get her to eat her daily extensively baked milk therapy dose, as she got very bored, very quickly with the plain muffin recipe provided by the allergist. We tried to make the muffins more exciting (and a bit more healthy) by adding allergy-friendly chocolate chips and some whole-wheat flour, but after two weeks, she would only eat them if doused in maple or chocolate syrup—not a good long-term strategy.
And in order for the baked milk therapy to be successful (i.e. in order for it to help her outgrow her milk allergy more quickly than she would have on her own, and allow her to qualify for a baked cheese challenge in a few months), she needs to eat 1-3 items containing 1/6 cup (or approximately 2 1/2 tablespoons) of extensively baked milk each day.
Clearly we needed some new, kid-friendly recipes to mix it up… but we faced three big challenges:
Challenge #1: Finding recipes that feature well-baked milk, but NOT her other allergens — eggs, sesame, tree nuts, peanuts and more. (And that don’t contain other forms of dairy that she has not been cleared to consume, like butter or cheese).
- The solution: start with a traditional (i.e. non-vegan) recipe, and replace the eggs, butter and other allergens with our safe allergy-friendly equivalents. (I also considered starting with a vegan recipe and just swapping in cow milk for our usual oat or soy milk, but I wasn’t sure how the fats and sugars in the cow milk might throw off the recipe).
Challenge #2: Finding recipes with ENOUGH milk per serving. The baked milk therapy recipe provided by our allergist at Mount Sinai contained 2 cups of milk for 12 muffins — but most muffin, scone, biscuit and bread recipes I’ve been able to find contain half that much milk or less. And just doubling the liquid milk in a recipe would probably result in gooey, runny disaster.
- The solution: amp up to the right dose of milk protein per serving by adding dry powdered milk. I checked with the allergist’s office, and they cleared us to add extra dry milk to a recipe to achieve the right dosing per serving. (Apparently this is actually standard in some of the baked milk therapy recipes used by other hospitals).
Challenge #3: Sourcing allergen-free fresh and dry milk free that is either organic or rBGH hormone free. We initially made our muffins with Organic Valley Whole Milk on the assumption that liquid milk should be relatively free of cross-contamination or contact with nuts—and obviously she did not react to the milk—but I was alerted by some other allergy parents that they may have shared facilities or equipment with tree nuts, peanuts and other allergens. ARGH.
- The solution: call or email various milk companies until I find something safe. So far I have reached out to Organic Valley, Horizon Organic and Stonyfield (for liquid organic milk) and to Now Foods (for organic powdered dry milk). Their answers were mixed, but there seems to be a stronger chance of nut or peanuts present for Organic Valley and Horizon, while Stonyfield is nut-free but has shared (though well-cleaned) lines with eggs. Now Foods makes many allergen-containing products, but I was pretty satisfied with their email as they say they test for allergens to ensure no cross-contact (see all email responses at bottom of this post). For now I think we will use Stonyfield, but I am also going to investigate other sources (such as milk from our local farmer’s market), since as a Paranoid Allergy Mom, I really prefer items with more of an allergen-free guarantee.
With these solutions in hand, I decided to adapt one of my favorite recipes from pre-food allergy days — the Cherry-Chocolate Scones from King Arthur Flour’s wonderful Whole Grain Baking book. (Ironically, because I am lactose intolerant, I used to make these with eggs and butter… but with rice milk instead of cow milk. Also: we don’t use King Arthur flour any more due to sesame allergy, but if you can use it, it’s wonderful stuff).
The adapted scones were a HUGE hit, and baked milk dosing has not been a problem at all for the last week — if anything, she clamors for more scones and is disappointed she can only have one at a time.
However, the dough does come out a bit runnier and stickier than the original allergen-packed version I used to make, which could be easily kneaded and shaped into triangles:
I did manage to coax some of these into triangles, but I think next time I’ll just treat them like large, sweet drop biscuits.
- 2 ½ cups safer whole-wheat pastry flour (we use Hodgson Mills)
- 1 cup safer all-purpose unbleached wheat flour (we use Gold Medal)
- ¼ cup granulated sugar
- ¼ cup brown sugar
- 1 tsp. baking soda
- 1 tsp. baking powder
- ½ tsp. salt
- ½ cup cold vegan butter substitute (we use Earth Balance Soy Garden as it is does not contain peas or canola)
- ¾ cup safer dried fruit (such as Newman’s Own dried cherries or Newman’s Own dried cranberries, which are both nut-free, or dried fruit from Gerb's)
- ¾ cup Enjoy Life chocolate chips or chunks
- 1 ½ tsp Ener-G Egg Replacer
- 1 cup of buttermilk (we used plain organic whole milk, curdled into buttermilk with a tablespoon of lemon juice or apple cider vinegar)
- 4 tbsp. safer dry milk powder (we used Now Foods Organic Nonfat Dry Milk Powder, other folks swear by Nestlé Carnation powdered milk)
- 2 tsp. McCormick vanilla extract (our go-to safer vanilla)
- Preheat oven to 375 degrees F.
- Line a baking sheet with parchment paper.
- Make buttermilk — whisk a tablespoon of lemon juice or apple cider vinegar into milk in large measuring cup, and allow to curdle. Allow to sit for five minutes, then whisk in the 4 tablespoons of dry milk powder to achieve correct baked milk dosing per each scone.
- In a large bowl, whisk together most of the dry ingredients — flour, sugar, baking powder, baking soda, salt.
- Cut the cold Earth Balance or other vegan butter replacement into the dry ingredients with a fork until mixture has a coarse breadcrumb texture. Gently stir in safe dried fruit and chocolate chips.
- Whisk Ener-G egg replacer and vanilla into measuring cup containing buttermilk and milk powder.
- Dump liquid from measuring cup into dry ingredients, mix lightly and quickly with a fork until barely combined.
- Knead dough on lightly floured work surface 2 - 3 times.
- Divide dough in 16 equal portions, shape into rounds or triangles, and place on lined baking sheet. (The dough may be too sticky for proper triangles—round drop scones may work better).
- Bake for 30 to 35 minutes or until golden brown and firm to the touch AND toothpick comes out clean. It is VERY important that the scones be not even SLIGHTLY undercooked or soft/wet--better they are slightly burnt than undercooked.
- Give child scone carefully, watch for two hours for signs of allergic reaction.
Safer sourcing ideas:
DISCLAIMER: Please proceed with caution, read labels, check with companies yourself and use these allergy-friendly sourcing ideas as a starting place only. These are the options that work for our particular family and our daughter’s allergies and sensitivities as of the time of this writing. Ingredients and labels and cleaning practices can change at any time without warning.
- All-Purpose Flour: Our current general go-to flour for all-purpose, bread and whole wheat is Gold Medal (they’re part of General Mills, which has a labeling policy for all of our allergens, including sesame).
- Whole Wheat Pastry Flour: Hodgson Mill’s wheat flours and corn meals were sesame-free and nut-free as of a recent email, so I use their whole wheat pastry flour quite a bit. You might try using Gold Medal White Whole Wheat flour—it’s rather hard to find, but they seem to carry it at Wal-Mart and on Soap.com.
- Chocolate chips and chunks: Enjoy Life chocolate chips and chocolate chunks are Top 8+ free, and our most trusted safer option — I often get them as part of a bulk order from Vitacost. I like to mix them up in the same batch of cookies.
- Sweeteners: If you want to go for a more natural or fair-trade sweetener,Wholesome Sweeteners sells organic and fair-trade raw and less-processed sweeteners that were free of contamination from dairy, nuts, sesame, eggs and more as of February 2014 (this does NOT include their Stevia product).
- Vanilla extract: We use McCormick vanilla (available as an Amazon subscription), as that is our go-to-brand for safer single spices and extracts. As of a recent email, they seem to take allergen safety, cleaning and cross-contamination very seriously. (Most other spice companies I’ve contacted run everything on shared lines with mustard and sesame).
- Egg Replacer: We use Ener-G egg replacer or when less lazy, ground flaxseeds, to sub for eggs. We get whole flax seeds as part of regular bulk orders from Gerb’s to ensure they won’t be contaminated with sesame, but there may be more easily available sources if you don’t have all of our allergies.
- Vegan butter substitute: Kiddo is allergic to canola and peas, so our go-to is Earth Balance Soy Garden spread.
- Fresh Milk: I don’t really have a solid safer option here, but Stonyfield told me their milk is nut-free and peanut-free… though run on shared lines with egg-containing products (see responses at very bottom of this post). Horizon seems to take allergens seriously as well.
- Dry Milk: We use Now Foods Certified Organic Dry Nonfat Milk Powder. Facility is peanut-free, though not free of other allergens, but they told me they clean extensively and test for allergens, so this was in my comfort zone.
Really, the only problem with these scones is that they are bit fussier to make than muffins, and so tasty husband and I have been eating into our freezer supply and will have to make more soon.
Next I plan to try baking some soft whole-wheat dinner rolls, and maybe some baked donuts, English muffins or cornbread muffins… though I may have to delegate the baking of the above to my husband or mom, since I’m 38 weeks pregnant and will probably be lying in bed feeding the newborn around the clock for at least a few weeks.
I think the more different baked milk item options in the freezer, the less worry that she’ll get bored again (or at least, bored as quickly)? Right? Fingers crossed…
P.S. Here are the responses I got from various milk companies this week:
We do not own the majority of our production facilities, but work with many different production plants around the country to process our products. None of these production facilities are allergen free facilities. To mitigate the possibility of cross-contamination, each production facility practices a complete clean-up prior to organic processing, and all of our plants have Standard Operating Procedures (SOPs) and Good Manufacturing Practices (GMPs) they follow to avoid contamination with the ingredients from any other products run in their plants. All plants are audited to ensure compliance with SOPs and GMPs.
Unfortunately, we have multiple plants that produce our whole milk, and these plants may also produce our half and half creamers (hazelnut flavor) as well as other allergen-containing products for other companies.
I’m really sorry is this means your family will not be able to enjoy our products. I will be sure pass along your experience to our production team.
We understand your concern with regard to shared manufacturing equipment and appreciate the opportunity to share with you our commitment to producing safe food products.
While our Horizon Organic® milk does not contain peanuts or tree nuts, they are produced at a variety of facilities across the United States. Each of these facilities has a well-defined allergen control program, which includes the procurement and storage of raw ingredients, rigorous testing for the presence of dairy allergens in our finished product, and isolated production runs.
Our allergen control programs consist of several components, designed to comprehensively address allergenic food concerns at multiple points of production. Examples of this program include the following:
1. Supplier control – each ingredient used in production goes through steps to ensure quality and purity.
2. Cleaning procedures – validated procedures to ensure effective clean and rinse is accomplished after each production run.
3. Allergen-free product testing – testing in-process and finished product at frequent intervals to ensure safety.
4. Storage/warehouse – allergen status labeling and isolation of ingredients to ensure no cross-contamination occurs.
5. Production scheduling – scheduling of product runs are done in a manner that ensures allergen-containing products are run only after non-allergen containing products, protecting the immediate subsequent product from contamination risk.
In addition, these facilities follow Good Manufacturing Practices, which are the foundation of any food safety program and provide the guidelines for sanitary operations, including the sterilizing and cleaning of manufacturing equipment.
Food safety is our highest priority and as part of our commitment to quality, all employees involved in the manufacturing of Horizon Organic® have a comprehensive awareness of food allergen concerns.
Of course, anyone with severe allergies should always consult a doctor before introducing a new food.
Thanks for reaching out to us about our plain whole milk and whether it would be safe for your daughter to consume, given her allergies to tree nuts, peanuts and eggs.
Our plain whole milk has no exposure to peanuts or tree nuts, but unfortunately it is made on the same line as other products that are made with egg. The lines are thoroughly cleaned between runs of different products, but the risk of cross-contamination, while low, is never zero. We always like to be straightforward with our fans who have questions concerning allergies so that they can choose products that are safe for their families.
Thanks again for getting in touch. If you ever have another question please give us a shout.
We know there are thousands of customers like you who rely upon us to do our job well. Our GMP certification and extensive cleaning of the machines between runs limits potential cross contamination with other allergens including corn, gluten, dairy, eggs, other nuts, soy, wheat, and other allergens, including sesame. We are a peanut free processing facility. Our testing indicates our products to be free of cross contamination. We carefully handle our products, filter the air, and breakdown and clean packaging machines between runs.