Follow‐up of nutritional status and dietary survey in children with cow's milk allergy

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Abstract
The nutritional status of children with cow's milk allergy was followed during an elimination diet in 19 children (9 boys and 10 girls) beginning at the mean age of two years (range 0.6‐4.1 years). The cow's milk allergy had been verified in hospital by a challenge test at a mean age of 0.9 years (range 0.2‐1.9 years). Weight, height and laboratory indices to test protein, mineral and vitamin status were measured at three follow‐up visits at three‐month intervals. In addition to cow's milk allergy all these children had some other food allergies, and six of the 19 children were allergic to soy protein. Only two of the 19 children were given a soy‐based formula. In the diets of the other children, cow's milk was replaced by increasing amounts of other foodstuffs and supplementary calcium. At the beginning of the study the relative heights of the children were slightly retarded (– 0.6 SD) and remained unchanged during follow‐up (– 0.8 SD at the end of the study). The relative weights were found to be decreased during follow‐up (p < 0.05). There was a significant reduction in serum prealbumin values; eight of the 19 children showed abnormally low values. Low serum zinc values were seen in 12 children. Serum iron concentration was low in two children and two had high serum alkaline phosphatase values. Seven‐day food recording indicated that dietary intake of energy was below the recommendation in some children, but protein intake was high. Some children had low intakes of riboflavin. Correlations between dietary intake and nutritional status were not seen in the children with cow's milk allergy. Careful follow‐up of children with cow's milk allergy is indicated and should include the monitoring of relative height and weight, serum prealbumin, serum trace elements and individual diet prescriptions.