ESPE Abstracts (2019) 92 P3-28

Linear Growth in Children with COW Milk Allergy and their Response to Hypoallergenic Diet; Significant Catch-Up in the First 6 Months

Mona Shaat, Ashraf Soliman, Maya Itani, Celine Jour, Sohair Elsiddig, Fatima Souieky, Noora Al-Naim, Mohammad Ehlayel


Hamad General Hospital, Doha, Qatar


Introduction: Milk allergy is an adverse immune reaction to proteins in cow's milk. Treatment consists of eliminating milk from the diet. Controversy exists about the effect of CMA and the use of hypoallergenic formula on linear growth in these children.

Objectives: To evaluate the growth status of children with CMA at their first presentation and after 6 months of hypoallergenic formula.

Material and Methods: An observational, longitudinal, retrospective study was done on all infants and children diagnosed with CMA and who had high serum IgE level diagnosed between 6-2016 and 12- 2017. The following data were analyzed: chronology and type of feeding, the presence of allergy to other foods, atopic dermatitis or other symptoms of allergy, duration of CMA, and anthropometric data (weight and height) at diagnosis, and follow up after 6 months. Anthropometric data were expressed as Z-scores.

Results: A total of 20 children aged between 2 months to 59 years, with a mean age = 1.34 +/- 1.9 years were studied. Allergy to foods other than milk was found in 35%. At first presentation their BMISDS = -0.12 +/- 1.3, with 3/20 had BMISDS < -1.5. Their Ht SDS = -0.68 +/- 1.057, with 4/20 children with HTSDS < -2. After 6 months of taking hypo-allergic formulae the BMISDS = -0.196 +/- 1.1 and only 1/20 children had BMISDS < -1.5. This child has a significant catch up in HSDS from -1.6 to -1.1 which explained the same BMISDS despite gaining weight properly. After hypoallergic diet their HtSDS = -0.497 +/- 0.97 only 1/20 who had multiple food allergies had HtSDS < -2 with low weight gain (4.4 g/day during the treatment period).

Conclusions: Our study showed that 20% of children with CMA had short stature and 15% had low weight for height at presentation. Improvement of linear growth and weight gain was observed in these patients when put on hypo-allergenic formula. The rest of the children, with normal anthropometric data at presentation, continued to grow normally on a hypoallergenic diet. The presence of other food allergies might affect weight gain and linear growth in some children

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