Dr. Agata Stróżyk, a dietitian at the Medical University of Warsaw, shared her expertise on the “food ladder” in both theory and practice, providing insights for clinicians, patients, and families. She addresses questions such as:

• Could you explain what a food ladder is?

• What steps does a child typically go through during the food ladder process?

• What are the key benefits of milk and egg reintroduction for patients and families?

• What positive outcomes do you observe clinically?

• At the same time, what are the most common barriers and facilitators to successful reintroduction, and how important is it to monitor each step of the ladder carefully to ensure safety and build confidence in both the child and the caregivers?

• As a dietitian, what practical advice would you give to clinicians conducting an oral food challenge with baked milk or egg? For example, how can existing recipes be adapted to match a child’s individual food preferences or their stage of oral-motor development?

• What would you suggest if a child with a food allergy is also a picky eater or has multiple food allergies – such as to both milk and wheat?

Below are references she has selected to guide listeners in addressing these questions.

Literature

• Venter C et al. Better recognition, diagnosis and management of non-IgE-mediated cow's milk allergy in infancy: iMAP – an international interpretation of the MAP (Milk Allergy in Primary Care) guideline. Clin Transl Allergy. 2017 Aug 23;7:26. doi: 10.1186/s13601-017-0162-y. eCollection 2017. PMID: 28852472; cf. also Correction to: Venter C et al. Better recognition, diagnosis and management of non-IgE-mediated cow's milk allergy in infancy: iMAP – an international interpretation of the MAP (Milk Allergy in Primary Care) guideline. Clin Transl Allergy. 2018 Jan 25;8:4. doi: 10.1186/s13601-017-0189-0. eCollection 2018. PMID: 29416848

• Meyer R et al. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guideline update – VII: Milk elimination and reintroduction in the diagnostic process of cow's milk allergy. World Allergy Organ J. 2023 Jul 24;16(7):100785. doi: 10.1016/j.waojou.2023.100785. eCollection 2023 Jul. PMID: 37546235. PMCID: PMX10401347

• Gibson V et al. Barriers and enablers of dietary reintroduction following negative oral food challenge: A scoping review. J Allergy Clin Immunol Pract. 2025 Apr;13(4):851-860.e7. doi: 10.1016/j.jaip.2025.01.012. Epub 2025 Jan 17. PMID: 39828135

  Dr. Stróżyk´s favourite song is: Małomiasteczkowy - Dawid Podsiadło

ESPGHAN favourite songs can be found on Spotify: https://open.spotify.com/playlist/0YIHKjxITLEm9XNyHyypTo