Cow's milk allergy in children: adherence to a therapeutic elimination diet and reintroduction of milk into the diet

Jetta Tuokkola (1) , Minna Kaila (1) , Carina Kronberg-Kippilä (1) , Harri Sinkko (1) , Timo Klaukka (1) , Pirjo Pietinen (1) , Riitta Veijola (1) , O Simell (1) , Jorma Ilonen (1) , Mikael Knip (1) , Suvi M. Virtanen (1)

1 Department of Public Health

Background/Objectives: The basic treatment of cow's milk allergy (CMA) is the elimination of all cow's milk proteins (CMP) from the diet. The present study aimed at characterising the diet of children with a diagnosis of CMA, to assess the degree of adherence to the elimination diet and to evaluate factors associated with the adherence and age of recovery. Subjects/Methods: From a birth cohort study, food records of 267 children with diagnosed CMA were studied to define how strictly the elimination diet was adhered to. Subsequent food records were studied to assess the age at reintroduction of milk products in the child's diet. Results: The families adhered to the elimination diet of the child with extreme accuracy in 85% of the cases. Older and monosensitised children had more often small amounts of CMP in their diet, possibly due the absence of nutritional information by a dietitian/nutritionist. Adherence to the diet was not related to any other sociodemographic factor studied nor to the age at reintroduction of milk products into the diet. Conclusions: The therapeutic elimination diet of children with a diagnosed CMA was well adhered to. Low intakes of vitamin D, calcium and riboflavin are of concern in children who follow or have followed a cow's milk-free diet.

Mots clés: adherence; child; preschool; cow's milk allergy; elimination diet; infant

Jetta Tuokkola, Minna Kaila, Carina Kronberg-Kippilä, Harri Sinkko, Timo Klaukka, et al.. Cow's milk allergy in children: adherence to a therapeutic elimination diet and reintroduction of milk into the diet. European Journal of Clinical Nutrition, 2010, ⟨10.1038/ejcn.2010.132⟩. ⟨hal-00563103⟩