Diet and nutritional status in children with cow's milk allergy

The purpose of this study was to investigate the nutritional status and adequacy of the diet in the children with cow's milk allergy (CMA).

18 children with challenge-proven CMA and 20 healthy children were investigated in the cross-sectional study. The mean (range) age of the children was 2.0 (1.0-3.5) years. The healthy children were matched by age and sex with the allergic children. Food consumption data were collected by the six-day food record method. The weight and height of both groups and laboratory indices of children with CMA were measured to study the nutritional status.

Thirteen (72%) of the children with CMA used a formula based on soy or casein hydrolysate. The amounts of these formulas consumed by the allergic children were smaller (371 ml vs 559 ml; P < 0.01) than the amount of milk and milk products consumed by the healthy children. There was no difference in energy intake between the groups. Protein intake by the allergic children was lower (39 g vs 48 g; P < 0.05) and fat intake higher (47 g vs 39 g; P < 0.05) than that of the healthy children. The mean intakes of energy and zinc in both groups, and the intake of iron in the healthy children, were below the RDAs. The diet in the allergic children was supplemented with calcium and in 11 children with vitamins A and D. Fourteen healthy children had vitamin A and D supplement. The height-for-age was lower in the children with CMA (-0.6 vs +0.2 s.d. units; P < 0.05) as compared to healthy children. Serum biochemical measurements were within the reference range in the allergic children, and no nutritional problems were found.

For the eliminated foods children with CMA substituted nutritionally corresponding food items which resulted in adequate mean intakes of nutrients. Specific formulas contributed substantially to the nutrient intake. Children with CMA need intensive nutritional counselling and regular monitoring of growth.