Dziechciarz Piotr, Stróżyk Agata, Horvath Andrea, Cudowska Beata, Jedynak-Wąsowicz Urszula, Mól Nina, Jarocka-Cyrta Elżbieta, Zawadzka-Krajewska Anna, Krauze Agnieszka
Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland.
Department of Paediatrics, Gastroenterology, Hepatology, Nutrition and Allergology, Medical University of Bialystok, Bialystok, Poland.
J Pediatr Gastroenterol Nutr. 2024 Jul;79(1):131-139. doi: 10.1002/jpn3.12139. Epub 2024 Jan 30.
BACKGROUND/OBJECTIVES: To assess the nutritional status and incidence of feeding difficulties in Polish children up to 2 years of age with cow's milk allergy (CMA) on cow's milk proteins-free diet.
A cross-sectional, multi-center study included children aged 6 months to 2 years with confirmed or suspected (without oral food challenge) diagnosis of CMA on the elimination diet for at least 1 month. The primary outcomes were an assessment of proportion of children with impaired nutritional status (with the weight for length and body mass index (BMI) z-score > 1 and <-1), and feeding difficulties according to the Montreal Children's Hospital Feeding Scale. Children with confirmed and suspected CMA were assessed separately.
A 144 children with confirmed CMA and 88 with suspected CMA were included (57 and 78% with multiple food allergies, respectively). Among children with confirmed CMA, one-third (35.5%) of participants had any nutritional status impairment regardless of definition. Among those, most of children had mild malnutrition (10.4 vs. 9%) and possible risk of overweight (11.1 vs. 9.7%; following respectively BMI for age and weight for length z-scores). Only 16.0% of children had feeding difficulties. Feeding difficulties was identified to be a risk factor for moderate malnutrition compared to children without feeding difficulties (odds ratio 10, 95% confidence interval: 4-27).
Mild malnutrition and possible risk of overweight are concern in children up to 2 years of age on cow's milk proteins-free diet. Feeding difficulties are less common, however, may affect the nutritional status.
背景/目的：评估采用不含牛奶蛋白饮食的波兰2岁以下牛奶过敏（CMA）儿童的营养状况及喂养困难发生率。
一项横断面多中心研究纳入了6个月至2岁、经确诊或疑似（未经口服食物激发试验）CMA且接受排除饮食至少1个月的儿童。主要结局指标为评估营养状况受损儿童的比例（身长体重比及体重指数（BMI）z评分＞1且＜-1），以及根据蒙特利尔儿童医院喂养量表评估的喂养困难情况。确诊和疑似CMA的儿童分别进行评估。
纳入了144例确诊CMA儿童和88例疑似CMA儿童（分别有57%和78%对多种食物过敏）。在确诊CMA的儿童中，无论采用何种定义，三分之一（35.5%）的参与者存在营养状况受损。其中，大多数儿童为轻度营养不良（分别为10.4%和9%）以及可能存在超重风险（分别为11.1%和9.7%；分别按照年龄BMI和身长体重z评分）。只有16.0%的儿童存在喂养困难。与无喂养困难的儿童相比，喂养困难被确定为中度营养不良的一个风险因素（比值比10，95%置信区间：4 - 27）。
采用不含牛奶蛋白饮食的2岁以下儿童存在轻度营养不良及可能的超重风险。喂养困难较少见，但可能影响营养状况。
