About non-IgE soy allergy

The concept of the ladder is that smaller amounts of soya, and soya that has been more cooked, baked or processed, are less likely to cause allergic reactions.

• Step 1 begins with bread or bakery foods containing small amounts of well-baked soya. The further steps give examples of foods with gradually less cooked soya.
• Before starting the ladder and progressing to each further step, ensure that your child is well, that any symptoms are settled and any eczema is well-managed and not flaring.
• Not all food examples for each step need to be tried. Use the foods that you feel most comfortable cooking and preparing or that your child will be most likely to eat.
• The steps marked with (*) are considered optional for families who would struggle to include these foods. For children who experience distressing symptoms after soya ingestion it may be more important to include all steps to achieve a very gradual soya introduction.
• Soya allergy occurs to the protein in soya. Soya oil and soya lecithin (E322) contain little, if any, soya protein. Most children with soya allergy tolerate these ingredients and are able to include them in their diet. They have therefore not been included on the ladder. A minority of children might still react to these ingredients and will need to avoid them.
• On each step, it is recommended to start a food in small amounts only and gradually build up to what is a full portion for your child whilst monitoring for any symptoms.
• Offer the food every day, every other day or 2 to 3 times per week depending on how quickly you might see symptoms.
• Ensure that your child has tolerated a full portion of the food at least 2 to 3 times before trying a food on the next step of the ladder.
• The amount of time spent on each step will vary from one child to another, depending on how quickly symptoms occur, how gradually the food is introduced and other factors.
• If the food on any step is tolerated, your child can continue to consume this (as well as foods in previous steps) whilst trying the food on the next step.
• If your child does not tolerate a food in a particular step, simply go back to the previous step and re-try again in approximately three months’ time. If the reaction is very mild, you could try an alternative food on the same step.
• Soya is a bean and can cause digestive discomfort for some people. If digestive issues occur (such as bloating, tummy ache, wind, loose stools or altered bowel habits), consider whether this is in-keeping with your child’s allergy symptoms or whether it could be a digestive issue. Introducing soya gradually and in smaller amounts can help to reduce digestive symptoms.

Step 1

Soya in bread or bakery foods

• Bread with soya flour: start with a stamp-pieced size → 1/8th slice → one quarter slice → half slice → 1 slice upwards
• Wheat-free options: biscuits, cake, crackers, bread, rolls containing soya.

Wheat- and gluten-free options for step 1:

• Gluten free bread, rolls, crackers or biscuits that contain soya flour or soya protein, (Note: Ingredients can change, always check the label!) For example:
  • Schar Gluten free bread, white roll, cream cracker, and digestive biscuits
  • New York bakery gluten free plain bagels
  • Sainsbury’s deliciously free from plain digestives and shortbread
  • Asda gluten free digestive biscuits
• Homemade bakery items (well-baked with a dry crumb) made with soya milk or soya yogurt

Step 2

Optional: Fermented soya*

• Soya-based sauces (soya sauce, teriyaki sauce, tamari sauce) and miso used as an ingredient in cooked foods. Use sparingly due to high salt content
• 1 tablespoon Natto or Tempeh (larger portions after step 4)

Step 3

Optional: Well-cooked soya* (Start small, build up to a full portion)

• Soya milk used in a white sauce or in mashed potato that is then oven-baked, for example, lasagne, pasta bakes, cottage pie, shepherd’s pie, fish pie
• Cooked soya mince or textured, hydrolysed vegetable protein (TVP/HVP), Soya nuts

Step 4

Whole soya foods, lightly cooked (Start small; build up to a full portion).

• Well-boiled soya milk, for example, white sauces, porridge and milky puddings (custard or rice pudding) made with well-boiled soya milk
• Fried tofu, soya-based vegetarian sausage or burger

Step 5

Whole soya foods, lightly processed (Start with 1 spoon and gradually increase)

• Soya-based yogurt, fromage frais, dessert and ice cream
• Soya-based spread or margarine, Wow butter

Step 6

Whole soya foods, uncooked (start with 1 tablespoon or 1 oz mixed into usual milk).

• Soya milk, soya formula
• Fresh or frozen soya beans and edamame beans.