Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Growth in Infants with Cow's Milk Protein Allergy Fed an Amino Acid-Based Formula

  • Received : 2020.08.17
  • Accepted : 2021.05.04
  • Published : 2021.07.15
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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 proteinfree complementary diet, supported normal growth till 9 months of age in a cohort of Chinese infants with challenge-confirmed non-IgE-mediated CMPA.

Keywords

Acknowledgement

The authors wish to thank all the families and infants who participated in the study. The contributions of all investigators and study staff at the 10 research sites in China are also gratefully acknowledged. We gratefully acknowledge the contribution of the MOSAIC Study Investigator Group in China who co-ordinated and supervised the study: • Professor Xiaomei Tong, University Third Hospital, Beijing. • Professor Yan Hu, Children's Hospital of Chongqing Medical University, Chongqing. • Professor Liyan Zhang, Children's Hospital of Fuzhou, Fujian. • Professor Jieling Wu, Maternal and Child Health Care Hospital, Guangzhou, Guangdong. • Professor Shufen Yang, Second Affiliated Hospital of Harbin Medical University, Ha'erbin, Heilongjiang. • Professor Xiao Qin Li, Children's Hospital of Zhengzhou, Henan. • Professor Yan Zhong, Hunan Children's Hospital, Hunan. • Professor Jinjin Chen, Children's Hospital of Shanghai, Shanghai. • Professor Qing Zhao, Children's Hospital of Shanxi Women Health Center, Taiyuan, Shanxi. • Professor Zhen-yang Zhao, Children's Hospital Zhejiang, University School of Medicine, Hangzhou, Zhejiang.

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