Growth in Infants with Cow's Milk Protein Allergy Fed an Amino Acid-Based Formula

Fecha de publicación: 01/07/2021 Fecha Ahead of Print: 05/07/2021

Autores de IIS La Fe

• 

  Carmen Ribes Koninckx

  Autor

Participantes ajenos a IIS La Fe

• Vandenplas, Yvan
• Dupont, Christophe
• Eigenmann, Philippe
• Heine, Ralf G.
• Host, Arne
• Jarvi, A
• Kuitunen, Mikael
• Mukherjee, Rajat
• Szajewska, Hania
• von Berg, Andrea
• Zhao, Zheng-Yan
• Mosaic Study Investigator Grp

Grupos

• Enfermedad celíaca e Inmunopatología digestiva

  

  Leader

  Carmen Ribes Koninckx

Abstract

Purpose: The present study assessed the role of an amino acid-based formula (AAF) in the growth of infants with cow's milk protein allergy (CMPA). Methods: Non-breastfed, term infants aged 0-6 months with symptoms suggestive of CMPA were recruited from 10 pediatric centers in China. After enrollment, infants were started on AAF for two weeks, followed by an open food challenge (OFC) with cow's milk-based formula (CMF). Infants with confirmed CMPA remained on AAF until 9 months of age, in conjunction with a cow's milk protein-free complementary diet. Body weight, length, and head circumference were measured at enrollment and 9 months of age. Measurements were converted to weight-for-age, length-for-age, and head circumference-for-age Z scores (WAZ, LAZ, HCAZ), based on the World Health Organization growth reference. Results: Of 254 infants (median age 16.1 weeks, 50.9% male), 218 (85.8%) were diagnosed with non-IgE-mediated CMPA, 33 (13.0%) tolerated CMF, and 3 (1.2%) did not complete the OFC. The mean WAZ decreased from 0.119 to -0.029 between birth and enrollment (p=0.067), with significant catch-up growth to 0.178 at 9 months of age (p=0.012) while being fed the AAF. There were no significant changes in LAZ (0.400 vs. 0.552; p=0.214) or HCAZ (-0.356 vs. -0.284; p=0.705) from the time of enrollment to age 9 months, suggesting normal linear and head growth velocity. Conclusion: The amino acid-based study formula, in conjunction with a cow's milk protein-free complementary diet, supported normal growth till 9 months of age in a cohort of Chinese infants with challenge-confirmed non-IgE-mediated CMPA.

Keywords

• Anthropometry; Food hypersensitivity; Nutrition; Infant formula; Challenge test