Nutri_22-0054

Autores/as

Palabras clave:

Cow’s milk protein allergy, Growth, Infant.

Resumen

Objective

To assess linear growth and weight gain in infants with suspected cow’s milk protein allergy with gastrointestinal manifestations, seen at a gastropediatrics clinic.

Methods

A retrospective cohort study conducted with demographic, clinical, anthropometric and dietary information on 84 infants first seen between 2015 and 2018 and followed-up for six months. Stature-for-age, weight-for-age, and body mass index-for-age in z-scores were evaluated according to the cut off points established by the World Health Organization in 2006. Accelerated growth or catch-up was considered a gain ≥0.67 in the z-score of the referred indices, evaluated at 3 and 6 months.

Results

Median age at baseline was 4.0 months and 88.1% of the infants were already in diet exclusion. Regarding the anthropometric evaluation short stature frequency was 15.5% and the underweight frequency was 8.3% and 3.6% respectively based on the weight-for-age and body mass index-for-age indices. High recovery growth was observed during the follow-up period but was not considered catch up. In boys, the gains in weight-for-age and body mass index-for-age were significant (p=0.02 and p=0.01 respectively) and close to the threshold that characterizes the catch up, 0.58 and 0.59, respectively. In girls, significant gains in stature-for-age and weight-for-age (0.38 and 0.37 respectively, p=0.02 for both) were observed.

Conclusion

Infants with suspected cow’s milk protein allergy with gastrointestinal manifestations should have early access to specialized nutritional counseling to avoid exposure to allergenic food and control allergy symptoms, thereby avoiding malnutrition and ensuring adequate nutritional recovery.

Citas

Onis M, Garza C, Onyango AW, Borghi E. Comparison of the WHO Child Growth Standards and the CDC 2000 Growth Charts. J Nutr. 2018;137(1):144-8. https: //doi.org/10.1093/jn/137.1.144

Leroy JL, Frongillo EA, Dewan P, Black MM, Waterland RA. Can children catch up from the consequences of undernourishment? evidence from child linear growth, developmental epigenetics, and brain and neurocognitive development. Adv Nutr. 2020;11(4):1032-41. https://doi.org/10.1093/advances/nmaa020

Dupont C, Chouraqui J, Linglart A, Bocquet A, Darmaun D, Feillet F, et al. Nutritional management of cow’s milk allergy in children: an update. Arch Pédiatrie. 2018;25:236-43. https://doi.org/10.1016/j.arcped.2018.01.007

Labrosse R, Graham F, Caubet JC. Non-ige-mediated gastrointestinal food allergies in children: an update. Nutrients. 2020;12(7):1-28. https://doi.org/10.3390/nu12072086

Vieira MC, Morais MB, Spolidoro JVN, Toporovski MS, Cardoso AL, Araujo, et al. A survey on clinical presentation and nutritional status of infants with suspected cow’s milk allergy. BMC Pediatr. 2010;10(25):1-7. https://doi. org/10.1186/1471-2431-10-25

Meyer R, Koker C, Dziubak R, Godwin H, Dominguez-Ortega G, Chebar Lozinsky A, et al. The impact of the elimination diet on growth and nutrient intake in children with food protein induced gastrointestinal allergies. Clin Transl Allergy. 2016;6(1):1-7. https://doi.org/10.1186/s13601-016-0115-x

World Health Organization. WHO Child Growth Standards. Geneve: Organization; 2006.

Ong KKL, Ahmed ML, Emmett PM, Preece MA, Dunger DB. Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. BMJ. 2000;320:967. https://doi.org/10.1136/bmj.320.7240.967

Ministério da Saúde (Brasil). Guidelines for collection and analysis of anthropometric data in health services: technical standard system of food and nutrition surveillance – SISVAN. Brasília: Ministério; 2011.

Meyer R. Dietetic management of non-IgE mediated allergies in children. Paediatr Child Heal. 2018;28(5):241-4. https://doi.org/10.1016/j.paed.2018.03.008

Baker P, Melo T, Augusto NP, Machado P, Smith J, Piwoz E, et al. First-food systems transformations and the ultra-processing of infant and young child diets: the determinants, dynamics and consequences of the global rise in commercial milk formula consumption. Matern Child Nutr. 2020;17(2):1-18. https://doi.org/10.1111/mcn.13097

Fiocchi A, Schunemann H, Ansotegui I, Assa’Ad A, Bahna S, Canani RB, et al. The global impact of the DRACMA guidelines cow’s milk allergy clinical practice. World Allergy Organ J. 2018;11(1):1-7. https://doi.org/10.1186/ s40413-017-0179-7

Mahan LK, Raymond J. Krause: alimentos, nutrição e dietoterapia. 14a ed. Seattle: Elsevier; 2017.

Mericq V, Martinez-Aguayo A, Uauy R, Iñiguez G, Van Der Steen M, Hokken-Koelega A. Long-term metabolic risk among children born premature or small for gestational age. Nat Rev Endocrinol. 2017;13(1):50-62. https://doi. org/10.1038/nrendo.2016.127

Isolauri E, Sutas Y, Salo MK, 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. https://doi.org/10.1016/S0022-3476(98)70399-3

Giugliani ERJ. Growth in exclusively breastfed infants. J Pediatr. 2019;95(1):S79-84. https://doi.org/10.1016/j. jped.2018.11.007

Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. https://doi.org/10.1016/S0140- 6736(15)01024-7

Descargas

Publicado

2023-06-06

Cómo citar

ASSIS, P. P. de, menezes, J. S. da S., DINIZ, A. da S., ANTUNES, M. M. de C., & CABRAL , P. C. (2023). Nutri_22-0054. Revista De Nutrição, 35, 1–8. Recuperado a partir de https://periodicos.puc-campinas.edu.br/nutricao/article/view/8641

Número

Sección

ARTIGOS ORIGINAIS