Objective: To assess the food intake and the nutritional status of children on a cow s milk and cow s milk by-products free diet.Methods: Twenty-six children receiving a cow s milk and cow s milk by-products free diet were assessed during their first visit to the Pediatric Gastroenterology Clinic (mean age = 19.1 months). Thirty children with no food restriction (mean age = 16.8 months) were also assessed. The usual daily food intake method was used to make the dietary assessment. The food intake was compared between the groups and in relation to the Dietary Reference Intakes (DRIs). The z-scores for weight/age, height/age and weight/height were used to evaluate the nutritional status.Results: The cow s milk free diet group presented lower energy (p = 0.005), protein (p < 0.001), lipid (p < 0.001), calcium (p < 0.001) and phosphorous (p < 0.001) intake when compared to the control group. The number of children who had energy, calcium and phosphorous intake below the DRIs was higher in the cow s milk free diet group than in the control group. The z-score means for the cow s milk free diet and control groups were, respectively: height/age -0.81±1.06 vs +0.42±1.25 (p < 0.001), weight/age -1.03±1.21 vs +0.02±0.91 (p < 0.001), and weight/height -0.63±1.08 vs +0.30±1.11 (p = 0.004).Conclusions: During the cow s milk and cow s milk by-products exclusion therapy, qualitative and quantitative food intake monitoring must be carried out periodically, so as to prevent inadequacies in meeting nutritional requirements and impairment of growth and development.

The cholestatic group showed more severe nutritional deficits. Despite the evidence of lower iron intestinal absorption, cholestatic patients responded to oral iron therapy, probably, due to the coexistence of iron deficiency.

During the cow's milk and cow s milk by-products exclusion therapy, qualitative and quantitative food intake monitoring must be carried out periodically, so as to prevent inadequacies in meeting nutritional requirements and impairment of growth and development.

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