Persistent Cow’s Milk Allergy is Associated with Decreased Growth: A Longitudinal Study
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Karen A Robbins, MD, Robert A. Wood, MD FAAAAI, Corinne Keet, MD MS PhD
RATIONALE: Data on the effects of food allergy on growth are limited, with most studies providing only cross-sectional information in early childhood. Here we describe longitudinal data on growth in children with persistent food allergy to cow’s milk or peanut/tree nuts.

METHODS: A retrospective chart review was conducted for 191 children strictly avoiding cow’s milk (n=111) or peanut/tree nuts (n=80) due to IgE-mediated allergy, who had at least one clinic visit between the ages of 2-4 years, 5-8 years, and 9-12 years. Differences in height, weight, and BMI z-scores were analyzed by generalized estimating equation regression models.

RESULTS: In measurements from 1098 clinic visits, children with milk allergy had lower weight-(mean z difference 0.39,95%CI: 0.13– 0.66 ,p=0.004) and height-(mean z difference 0.39,95%CI: 0.11– 0.67,p=0.006), but not BMI-for-age (p=0.11) z-scores compared to peanut/tree nut allergic children. These differences were larger in the 5-8 yo (mean z difference 0.43,95%CI: 0.13–0.73,p=0.004) and 9-12 yo (mean z difference 0.52,95%CI: 0.21–0.84,p=0.001) age groups than the <5 yo age group for weight but not height (p<0.05 for interaction with age), and were unaffected by other atopic conditions, early-onset eczema, or inhaled corticosteroid use. Correspondingly, persistent milk allergy was associated with a greater decline in weight and also BMI z-scores from baseline visit (2-4 yo) (weight: mean z-difference 0.25, 95%CI: 0.06– 0.43, p=0.008, BMI: mean z-difference 0.34,95%CI: 0.09­– 0.59,p=0.007).

CONCLUSIONS: Persistent cow’s milk allergy may negatively influence growth through pre-adolescence. Further study is needed to better understand the complex relationship between food allergy and childhood growth patterns.