Nutritional status and food intake of children with cow's milk allergy

Boaventura, Renata Magalhães; Mendonça, Raquel Bicudo; Fonseca, Francisco A.H.; Mallozi, Márcia C.; Souza, Fernanda Silva de; Sarni, Roseli Oselka Saccardo

doi:10.1016/j.aller.2019.03.003

Cited by 33 publications

(39 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Concerning the comparison of anthropometric data of the two groups, children on an elimination diet had lower values of height-and weight-for-age compared to the control group (Table 1), as has been described before (1,11,14,22,23) . However, the three types of feeding difficulties were not associated with lower values of height in both elimination diet and control groups (Table 2).…”

Section: Discussionsupporting

confidence: 56%

“…According to recent reviews of the literature, the nutritional impact of picky eating is controversial (39,44) , but there is a subset of picky eaters at risk of poor weight gain, requiring early identification and nutritional surveillance (36) . Possible causes for faltering growth in children with CMPA are: the inadequacy of the elimination diet (22,23) , higher demand of nutrients due to increased gut permeability, the inflammation and production of inflammatory cytokines, and the deficiency of vitamins and minerals important for growth (14) , such as vitamina A and D (23) . In Brazil, the special formulas for children with CMPA are usually provided by the public healthcare services only until children are 24 months old.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Feeding difficulties in children fed a cows’ milk elimination diet

et al. 2021

View full text Add to dashboard Cite

Cross-sectional study that compared feeding difficulties in children aged 2 to 5 years fed a cow’s milk elimination diet due to food allergy with a control group on an unrestricted diet. All data were obtained online. Specific questionnaires evaluated three types of feeding difficulties: avoidant eating, picky eating, and feeding problems. The median scores of feeding difficulties in the elimination diet (n = 146) and control (n = 109) groups were, respectively: picky eating (31 vs. 27; p = 0.148), avoidant eating (3 vs. 3; p = 0.508) and feeding problems (38 vs. 34, p = 0.032). Picky eating was more frequent in the elimination diet (35.4%) than in the controls (23.3%; p = 0.042), but no difference was observed for avoidant eating (23.9% vs. 20.4%, p = 0.508) and feeding problems (32.1% vs. 28.4%, p = 0.541). Picky eating was associated with lower values of weight-for-age z-scores in both groups. Multivariate analyses identified associations of the three feeding difficulties with previous food refusal and/or inappetence in the elimination diet group. Current constipation and anticipatory gagging were associated with feeding difficulties in both groups. In conclusion, children on an elimination diet presented higher frequency of picky eating and higher scores of feeding problems. Picky eating was associated with lower values of weight-for-age z-scores. Food refusal and/or inappetence as clinical manifestations of food allergy were associated with feeding difficulties at the moment of the survey. Current constipation and anticipatory gagging were associated with picky eating, avoidant eating and feeding problems.

show abstract

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Feeding difficulties in children fed a cows’ milk elimination diet

et al. 2021

View full text Add to dashboard Cite

show abstract

“…A common qualitative theme identified in our study population was concern about nutritional sources for calcium and for high‐energy foods. Although we did not query children's nutritional status or anthropometry, these findings provide some context to reports in the literature in which children with challenge‐proven cow's milk allergy had significantly lower protein 19 and calcium intake 20,21 and height 19,20 than non–food‐allergic children 19…”

Section: Discussionmentioning

confidence: 94%

Milk allergy most burdensome in multi‐food allergic children

Abrams

Kim

Gerdts

et al. 2020

Pediatric Allergy Immunology

View full text Add to dashboard Cite

Background: Food allergy is a substantial health burden, which disproportionately affects children. Among children with food allergy, as many as 70% have multiple food allergies. Whereas the overall burden of food allergy on quality of life has been described, little is known about the burden of individual allergens. We aimed to examine the perception of burden among families with multiple food-allergic children. Methods: Parents of children with 1 + children with multiple food allergies including milk responded to online questions, including both open-ended and closed-ended questions on food allergy-related burdens of time, financial costs, social restrictions, and emotional demands. Results: Overall, 64 children (69.8% boys) of whom (73.0%) most were aged 10 and younger were included. Most had been diagnosed with food allergy in infancy and by a (pediatric) allergist. Other common allergies included peanut (65.6%), tree nuts (57.8%), egg (76.6%), and sesame (31.3%). Quantitatively, milk allergy was reported as carrying the most burden, including most socially limiting (81.5%), requiring the most planning (75.9%), causing the most anxiety (68.5%), most challenging to find "safe" or allergy-friendly foods (72.2%), and costly (81.5%). Qualitatively, we identified five themes that captured burdens associated with costs, marketing of milk products to children, risk of cross-contamination, ubiquity of milk/dairy and public confusion with lactose intolerance, and an unwillingness of others to accommodate the allergy. Conclusion: Parents whose children have multiple food allergies, including milk, report milk as the allergy associated with the greatest time, financial, social, and emotional burdens.

show abstract

“…3 If not treated correctly, CMPA can provoke nutritional deficiency, resulting in poor growth and decreased Vitamin D levels. 4,5 It is also thought that CMPA occurring in infancy is the…”

mentioning

confidence: 99%

Cost-effectiveness Analysis of Hypoallergenic Milk Formulas for the Management of Cow’s Milk Protein Allergy in the United Kingdom

Martins

Connolly

Minshall

2021

JHEOR

View full text Add to dashboard Cite

Background: Cow’s milk protein allergy (CMPA) is the most common food allergy in early childhood. In most children CMPA resolves by age 5 or 6; however, if not treated correctly can provoke nutritional deficiency resulting in poor growth. Management consists of excluding cow’s milk from the diet, with hypoallergenic formulas (or non-dairy alternatives) being introduced to meet nutritional requirements. Objectives: To compare the cost-effectiveness of hypoallergenic formulas in reducing allergic manifestations and promoting immune tolerance in infants with immunoglobulin E (IgE)-mediated symptoms of CMPA. Methods: A trial-based decision analytic cohort model was developed to simulate the occurrence of urticaria, eczema, asthma, rhinoconjunctivitis, or being symptom-free in infants with CMPA in the United Kingdom. Amino acid-based formula (AAF), extensively hydrolysed casein formula containing Lactobacillus rhamnosus Gorbach Goldin (EHCF+LGG), extensively hydrolysed whey formula (EHWF), and soy formula (SF) were compared using the National Health Service (NHS) perspective, 3-year time horizon and 3.5% discount rate for cost and health consequences. Hypoallergenic formulas comparative efficacy was sourced from a prospective cohort study. Resources required to manage allergic symptoms were sourced from published literature, validated by a UK clinician, and applied to UK cost resources. Results were reported as cost per additional child free from allergic manifestations at 3 years and cost per additional immune tolerant child at 3 years. Results: In the base case, infants receiving EHCF+LGG were associated with lower NHS resource use and improved CMPA tolerance. Over the 3-year treatment period, savings of £119, £476, and £1094 were achieved with EHCF+LGG compared to SF, EHWF and AAF, respectively. Infant formula accounted for the largest proportion of resource consumption averaging 44% for all comparators, with a minimum of 31% for SF and a maximum of 53% for AAF over 3 years. General practitioners’ visits constituted the second highest cost component, approximately 17% of total costs across comparators. The results were robust to deterministic and probabilistic sensitivity analyses. Conclusions: Compared to AAF, SF, and EHWF hypoallergenic formulas, EHCF+LGG was the most cost-effective, associated with lower total costs and contributing to a higher proportion of children being symptom-free and developing immune tolerance 3-years after diagnosis.

show abstract

Nutritional status and food intake of children with cow's milk allergy

Cited by 33 publications

References 24 publications

Feeding difficulties in children fed a cows’ milk elimination diet

Feeding difficulties in children fed a cows’ milk elimination diet

Milk allergy most burdensome in multi‐food allergic children

Cost-effectiveness Analysis of Hypoallergenic Milk Formulas for the Management of Cow’s Milk Protein Allergy in the United Kingdom

Contact Info

Product

Resources

About