Elimination diet in cow's milk allergy: risk for impaired growth in young children

J Pediatr. 1998 Jun;132(6):1004-9. doi: 10.1016/s0022-3476(98)70399-3.


Objective: The objective of this study was to evaluate the nutritional impact of therapeutic elimination diets and to identify risk factors predisposing infants with food allergy to poor growth.

Study design: We studied 100 children (mean age 7 months) with atopic dermatitis and challenge-proven cow's milk allergy and evaluated their growth during the symptomatic period before diagnosis and during the therapeutic elimination diet.

Results: Clinical control of symptoms was achieved in all patients. The mean length SD score and weight-for-length index of patients decreased compared with those in healthy age-matched children, p < 0.0001 and p = 0.03, respectively. Low serum albumin was present in 6% of the patients, 24% had an abnormal urea concentration, and 8% had a low serum phospholipid docosahexaenoic acid. The delay in growth was more pronounced in a subgroup of patients with early onset than in those with later of symptoms (F = 6.665, p < 0.0001). The duration of breast-feeding correlated positively with the sum of n-3 polyunsaturated fatty acids (r = 0.39, p = 0.001) and with the relative amount of docosahexaenoic acid (r = 0.36, p = 0.002).

Conclusion: A delicate balance exists between the benefits and the risks of elimination diets.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Child Development
  • Diet Therapy / adverse effects
  • Diet Therapy / methods
  • Energy Intake
  • Growth Disorders / epidemiology
  • Growth Disorders / etiology*
  • Humans
  • Infant
  • Infant Food
  • Infant Nutritional Physiological Phenomena
  • Milk Hypersensitivity / diagnosis
  • Milk Hypersensitivity / diet therapy*
  • Risk Factors
  • Skin Tests