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Iodine Status and Growth In 0-2-Year-Old Infants With Cow's Milk Protein Allergy
Rut Anne Thomassen1, Janne Anita Kvammen, Mari Borge Eskerud
1*Department of Paediatric Medicine, Division of Paediatric and Adolescent Medicine, Oslo University Hospital †Department of Internal Medicine, Clinical Nutrition, Lovisenberg Diaconal Hospital, Oslo ‡Department of Clinical Science, University of Bergen, Bergen §Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo.
Insights
Cow's milk protein allergy in infants is linked to a high prevalence of iodine deficiency and poor growth, particularly in breastfed infants. These conditions, however, were not found to be directly associated.
Area of Science:
- Pediatric Nutrition
- Endocrinology
- Allergy Research
Background:
- Cow's milk protein allergy (CMPA) is common in infants.
- Iodine is crucial for infant growth and neurodevelopment.
- The nutritional status of infants with CMPA requires further investigation.
Purpose of the Study:
- To assess iodine status in infants with CMPA.
- To evaluate growth parameters in this cohort.
- To identify predictors of iodine status and growth.
Main Methods:
- Observational cross-sectional study of 57 infants (<2 years).
- Analysis of two spot urine samples for iodine concentration.
- Dietary assessment via food records and questionnaires; anthropometric measurements.
Main Results:
- Median urinary iodine concentration was 159 µg/L; one-third showed iodine deficiency.
- Mainly breastfed infants had the highest risk (58% deficient).
- Malnutrition (underweight/wasting) affected 11% and was linked to feeding problems, not iodine status.
Conclusions:
- Infants with CMPA exhibit a high prevalence of iodine deficiency and poor growth, though not directly associated.
- Breastfed infants with CMPA are at increased risk for iodine deficiency.
- Feeding problems are associated with malnutrition in this population.
Objectives:
The aim of the present article was to investigate iodine status and growth in cow's milk protein allergic infants and to identify potential predictors of iodine status and growth.
Methods:
Fifty-seven infants under 2 years of age were included in an observational cross-sectional study. Two spot urine samples were collected and analyzed for iodine, together with a 3-day food record and a food frequency questionnaire. Urine iodine concentrations were compared with the WHO cut-off values for iodine deficiency. Measurements of weight, length, and head circumference at birth and study inclusion were converted to standard deviation scores. Subgroup analyses were performed on different feeding patterns, according to weaning status.
Results:
Median age was 9 months. Median urinary iodine concentration was 159 ug/L. One third of the children had urine iodine concentrations indicating iodine deficiency. Infants who were mainly breastfed were at highest risk and 58% were classified as deficient. Dietary factors positively associated with iodine excretion were intake of enriched baby cereals and meeting the dietary requirement for iodine. Stunting was present in 5%. Underweight and wasting was frequent at 11% and this was associated with food refusal and poor appetite, but not with iodine status. Growth failure was detected among boys.
Conclusions:
The present study suggests that cow's milk protein allergy children have high prevalence of iodine deficiency and poor growth, however the 2 conditions were not associated. The subgroup of mainly breastfed infants was at higher risk of iodine deficiency compared to weaned infants. Subjects with feeding problems had increased risk of malnutrition.
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