Supplementary Material for: Longitudinal Growth Trajectories in Children with Cow’s Milk Allergy: Effects of Elimination Diet and Post-Termination Period

Introduction: The primary dietary approach for managing cow's milk allergy (CMA) is the elimination diet. We aimed to compare the growth patterns of children with CMA during and after the elimination diet with healthy peers and identify influencing factors.
Methods: We compared 74 CMA children with age-matched healthy peers. Anthropometric data were collected during the third month of cow milk elimination diet (T1), three months after diet cessation (T2), and after ≥3 months of normal diet (T3). Control group measurements coincided. Nutrient intake was assessed by a 3-day record, and patient lab results were noted at T3.
Results: CMA children had consistently lower weight-for-age (WFA) and height-for-age (HFA) z-scores than controls. WtHt z-score of patients were lower than those of the healthy group at T2. HC z-scores of patients were lower than those of the healthy group at T0, T2, and T3. At T3, the HFA z-score of the CME group demonstrated a negative correlation with the duration of the elimination diet. (p=0.045). Inadequate intake of energy, vitamins A, E, B1, B6, C, folic acid, magnesium, and iron was significantly higher in CMA children (p<0.05). T3 WFA z-score correlated positively with fiber, vitamin B1, magnesium, and iron intake (p<0.05). T3 WtHt showed a positive moderate correlation with energy, protein, vitamin E, vitamin B1, vitamin B2, vitamin B6, calcium, magnesium, phosphor, iron intake (p<0.05).
Conclusions: Post-elimination diet, children with CMA need sustained monitoring and potentially micronutrient supplementation to match healthy peers' growth.