Clinical and Laboratory Evaluation of Faltering Growth in Infants with Cow’s Milk Protein Allergy
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 2, Pages 1088-1097
AbstractBackground: Cow's Milk protein Allergy (CMA) is a serious and potentially lifethreatening problem for an estimated
2.5 % of children. Infants with CMA are at risk of growth faltering, however, data are still
Objectives: The aim of the study was to assess growth and nutritional status in infants with CMA and to evaluate the implications of CMA in infants with flatteringgrowth.
Methods: This cross sectional study was performed in the period from April 2019 to September 2019 in Pediatrics Department of Zagazig University Hospitals. The study included 72 patients with CMA diagnosed by oral challenge test after elimination diet. Allergy work up included skin prick test and measuring specific (Immunoglobulin E)
IgEforCow'sMilkprotein(CMP)forallpatients.Thegrowthandnutritionalstatusofthepatients World Health Organization (WHO) growth charts and growth zscores for weight-for-age, weight-for-height and height-for-age, in addition to
Results: Data from 72 infants (43 male and 29 female) with age of 9.92 ± 5.853 months indicated that 9 out of 72
infants(12.5%)werediagnosedasImmediateIgEmediatedCMAwhiletheother63infants(87.5 %)wereconsidered delayed non-IgE mediated CMA. Twenty-five infant out of 72 (34.7%) suffered from faltering of growth. We found that 20.8% of infants had z score < -2SD as regard weight for age while (9.7%) and (4.3%) had z score < -2 SD as regard height for age and weight for height respectively. We also, found that 36.1% of infants suffered from iron deficiency anaemia with haemoglobin (11.16 ± 1.53) g/dl, while 29.2% of infants showed hypoalbuminemia with serum albumin level (2.9 ±0.177)g/dl.
GrowthfalteringandnutritionalproblemsaremajorconcernsininfantswithCMA. Propermanagement of infants with CMA including specialist dietetic advice and regular growth monitoring is mandatory to avoid these concerns. When evaluating an infant with flattering growth iron deficiency anaemia and/ or hypoalbuminemia physicians should include in their evaluation extensive search forCMA
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