Growth in Healthy Infants with Cow's Milk Protein Allergy Fed Extensively Hydrolyzed or Amino Acid-based Formulas

Overview

Journal BMC Nutr

Publisher Biomed Central

Specialty Nutritional Sciences

Date 2024 Jul 19

PMID 39030656

Authors

Armen Malekiantaghi

Mahbobeh Aghajani

Hosein Shabani-Mirzaee

Mohsen Vigeh

Kambiz Eftekhari

Affiliations

Soon will be listed here.

Abstract

Background: Cow's milk protein allergy (CMPA) is one of the most common food allergies in the first year of life. Special formulas for infants with CMPA include extensively hydrolyzed (EHFs) and amino acid-based (AAFs) formulas. The aim of this study was to evaluate the growth of infants fed with these special formulas.

Methods: This was a prospective chart review study that evaluated the growth criteria of infants with CMPA fed with EHFs or AAFs until one year of age. These infants were referred to the gastroenterology clinic of Bahrami Children's Hospital from April 2021 to April 2022. These infants were divided into two groups, the group fed with EHFs and AAFs. Then growth criteria were evaluated in both groups.

Results: Fifty-eight children were enrolled in the study, of which 51.7% were girls. Forty were consuming the EHFs formulas. The median time of both diagnosis and treatment was 60 days. The most common clinical manifestations were gastroesophageal reflux, dysentery, eczema, vomiting, and cough, respectively. The diagnosis of the disease in the AAFs group was significantly earlier than in the other group. The growth of children in both groups was completely proportional to their age and growth criteria at birth. Comparing the groups, all growth parameters were higher in the EHFs group.

Conclusion: This study showed that the growth criteria (weight, length, and head circumference) were suitable for each group and were in accordance with the WHO growth charts compared to the birth criteria. But in the group fed with EHFs, compared to AAFs, the growth rate was higher.

Citing Articles

Clinical, laboratory, and therapeutic differences between immunoglobulin E-mediated and non-immunoglobulin E-mediated cow's milk protein allergy in children.

Isa H, Abdulnabi M, Naser N, Lahmda F, AlAnsari N, Isa Z World J Clin Pediatr. 2025; 14(1):100386.

PMID: 40059903 PMC: 11686578. DOI: 10.5409/wjcp.v14.i1.100386.

References

Sova C, Feuling M, Baumler M, Gleason L, Tam J, Zafra H . Systematic review of nutrient intake and growth in children with multiple IgE-mediated food allergies. Nutr Clin Pract. 2013; 28(6):669-75. DOI: 10.1177/0884533613505870. View

Mehaudy R, Jauregui M, Vinderola G, Guzman L, Martinez J, Orsi M . Cow's milk protein allergy; new knowledge from a multidisciplinary perspective. Arch Argent Pediatr. 2022; 120(3):200-206. DOI: 10.5546/aap.2022.eng.200. View

Burks A, Harthoorn L, Van Ampting M, Oude Nijhuis M, Langford J, Wopereis H . Synbiotics-supplemented amino acid-based formula supports adequate growth in cow's milk allergic infants. Pediatr Allergy Immunol. 2015; 26(4):316-22. DOI: 10.1111/pai.12390. View

Meyer R, De Koker C, Dziubak R, Godwin H, Dominguez-Ortega G, Lozinsky A . The impact of the elimination diet on growth and nutrient intake in children with food protein induced gastrointestinal allergies. Clin Transl Allergy. 2016; 6:25. PMC: 4944436. DOI: 10.1186/s13601-016-0115-x. View

Mennella J, Ventura A, Beauchamp G . Differential growth patterns among healthy infants fed protein hydrolysate or cow-milk formulas. Pediatrics. 2010; 127(1):110-8. PMC: 3010087. DOI: 10.1542/peds.2010-1675. View

Vandenplas Y, Brough H, Fiocchi A, Miqdady M, Munasir Z, Salvatore S . Current Guidelines and Future Strategies for the Management of Cow's Milk Allergy. J Asthma Allergy. 2021; 14:1243-1256. PMC: 8548055. DOI: 10.2147/JAA.S276992. View

Berry M, Adams J, Voutilainen H, Feustel P, Celestin J, Jarvinen K . Impact of elimination diets on growth and nutritional status in children with multiple food allergies. Pediatr Allergy Immunol. 2015; 26(2):133-8. DOI: 10.1111/pai.12348. View

Tuokkola J, Luukkainen P, Nevalainen J, Ahonen S, Toppari J, Ilonen J . Eliminating cows' milk, but not wheat, barley or rye, increases the risk of growth deceleration and nutritional inadequacies. Acta Paediatr. 2017; 106(7):1142-1149. DOI: 10.1111/apa.13846. View

Robbins K, Wood R, Keet C . Milk allergy is associated with decreased growth in US children. J Allergy Clin Immunol. 2014; 134(6):1466-1468.e6. PMC: 4362703. DOI: 10.1016/j.jaci.2014.08.037. View

10.

Meyer R, Wright K, Vieira M, Chong K, Chatchatee P, Vlieg-Boerstra B . International survey on growth indices and impacting factors in children with food allergies. J Hum Nutr Diet. 2018; 32(2):175-184. DOI: 10.1111/jhn.12610. View

11.

Savino F, Giuliani F, Giraudi S, Galliano I, Montanari P, Dapra V . Analysis of Serum Th2 Cytokines in Infants with Non-IgE Mediated Food Allergy Compared to Healthy Infants. Nutrients. 2022; 14(8). PMC: 9028458. DOI: 10.3390/nu14081565. View

12.

Gamirova A, Berbenyuk A, Levina D, Peshko D, Simpson M, Azad M . Food Proteins in Human Breast Milk and Probability of IgE-Mediated Allergic Reaction in Children During Breastfeeding: A Systematic Review. J Allergy Clin Immunol Pract. 2022; 10(5):1312-1324.e8. DOI: 10.1016/j.jaip.2022.01.028. View

13.

Isolauri E, Sutas Y, Salo M, Isosomppi R, Kaila M . Elimination diet in cow's milk allergy: risk for impaired growth in young children. J Pediatr. 1998; 132(6):1004-9. DOI: 10.1016/s0022-3476(98)70399-3. View

14.

Maslin K, Dean T, Arshad S, Venter C . Fussy eating and feeding difficulties in infants and toddlers consuming a cows' milk exclusion diet. Pediatr Allergy Immunol. 2015; 26(6):503-8. DOI: 10.1111/pai.12427. View

15.

Mehta H, Groetch M, Wang J . Growth and nutritional concerns in children with food allergy. Curr Opin Allergy Clin Immunol. 2013; 13(3):275-9. PMC: 4280668. DOI: 10.1097/ACI.0b013e328360949d. View

16.

Berni Canani R, Nocerino R, Frediani T, Lucarelli S, Di Scala C, Varin E . Amino Acid-based Formula in Cow's Milk Allergy: Long-term Effects on Body Growth and Protein Metabolism. J Pediatr Gastroenterol Nutr. 2016; 64(4):632-638. DOI: 10.1097/MPG.0000000000001337. View

17.

Vandenplas Y, Dupont C, Eigenmann P, Heine R, Host A, Jarvi A . Growth in Infants with Cow's Milk Protein Allergy Fed an Amino Acid-Based Formula. Pediatr Gastroenterol Hepatol Nutr. 2021; 24(4):392-402. PMC: 8279827. DOI: 10.5223/pghn.2021.24.4.392. View

18.

Niggemann B, von Berg A, Bollrath C, Berdel D, Schauer U, Rieger C . Safety and efficacy of a new extensively hydrolyzed formula for infants with cow's milk protein allergy. Pediatr Allergy Immunol. 2008; 19(4):348-54. DOI: 10.1111/j.1399-3038.2007.00653.x. View

19.

Borschel M, Baggs G, Oliver J . Comparison of Growth of Healthy Term Infants Fed Extensively Hydrolyzed Protein- and Amino Acid-Based Infant Formulas. Nutrients. 2018; 10(3). PMC: 5872707. DOI: 10.3390/nu10030289. View

20.

Meyer R, De Koker C, Dziubak R, Venter C, Dominguez-Ortega G, Cutts R . Malnutrition in children with food allergies in the UK. J Hum Nutr Diet. 2013; 27(3):227-35. DOI: 10.1111/jhn.12149. View