Lisa Waddell

Dr Lisa Waddell

26 years' professional experience

My background:
I am a registered dietitian with 24 years paediatric experience who gained a PhD on nutrition in children with renal disease. In the community, my focus changed to the management of nutritional problems in infants, particularly food allergy. I was a member of both NICE and RCPCH food allergy working groups, gained an Education for Health Allergy degree module and joined the Allergy UK Health Advisory Board. Locally, I have written Area Prescribing Committee guidance on cow's milk allergy and lactose intolerance and am lead for the commissioned Nottingham food allergy care pathway.
About me:
As a parent of children with food allergies, I believe parents should have access to expert paediatric dietetic support when they need it. The mission for my private work; FANS (Food Allergy Nottingham Service) is to support early recognition and diagnosis of food allergy, including development of an online allergy clinical history tool.

Lisa’s support has helped 42 people.

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Lisa’s Expert Answers

  • Q
    How does the Milk Ladder work? Can we give fresh milk in mash or does it have to be cooked when at the Shepherds pie stage?
    A
    How to reintroduce cows milk with the Milk Ladder Milk Ladders for cow’s milk re-challenging are designed to move from highly baked cow’s milk in a flour matrix e.g. biscuits and breads, to cow’s milk containing meals baked in an oven e.g. pizza, shepherds pie, lasagne. The ladder then moves onto products where the cow’s milk proteins are altered by other means, such as by fermentation in cheese and yogurts, before starting the final phase of introducing cow’s milk. This is often done by using UHT or sterilised milk first which has a higher level of heat treatment before using fresh, pasteurised milk. Each stage should start with small amounts, gradually increasing to a normal portion before moving onto the next stage. Adding fresh milk to mashed potato could therefore be done as a first step in the final stage of the milk ladder. With the support of a dietitian through these stages can avoid confusion and enable smoother transitions.

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