IgE-mediated cow’s milk allergy is a significant clinical problem. It may be persistent in a large percentage of children. This allergy is associated with restrictive diet, limitations in social activities and anxiety arising from the fear of accidental exposure to the allergen and life-threatening anaphylaxis. Currently, elimination diet and education of the child and their caregivers are the basic approaches in IgE-mediated cow’s milk allergy. However, this strategy does not modify the natural course of allergy. The so-called milk ladder and specific immunotherapy with cow’s milk, which is still an experimental treatment, are methods allowing for increasing the reactivity threshold. Both treatments are causal and can lead to permanent milk tolerance in the patient. The scheme of dietary expansion in a child with IgE-mediated cow’s milk allergy using the milk ladder involves introducing food products containing milk that is processed to a varying degree. This method assumes that patients who can introduce baked dairy products into their diet develop tolerance to increasingly higher doses of allergen over time and, at the same time, less thermally processed products. Oral immunotherapy with cow’s milk involves administering the allergen, usually in the form of unprocessed milk, in increasing amounts until the target dose is reached. The article discusses the possibilities of inducing tolerance to cow’s milk proteins in IgE-mediated allergy using the milk ladder and oral immunotherapy, along with advantages and limitations of such approaches.