Regular intake of cow's milk with oral immunotherapy improves statures of children with milk allergies

Background: Children who avoid cow's milk (CM) because of food allergy may show disturbed growth. Calcium insufficiency, in particular, was reported among those who completely avoided dairy products. We retrospectively examined whether oral immunotherapy (OIT) affected the stature of patients who had completely avoided CM owing to their severe CM allergy.

Methods: The CM-OIT group included subjects who had completely avoided milk their entire lives and were administered OIT between 2009 and 2013. The complete milk avoidance (CM-Avoid) group included subjects who were diagnosed with a CM allergy using oral food challenges between 2013 and 2014 who subsequently avoided CM completely. By examining clinical records and questionnaires, we investigated patient height changes over time. We calculated age- and sex-stratified height standard deviation scores (HtSDS) and analyzed changes in HtSDS retrospectively. The observation period was 1-2 years. To exclude pubertal growth spurts, we set the age criteria as less than 11 years in boys and less than 9 years in girls.

Results: We recruited 29 patients (19 boys) for the CM-OIT group and 20 (9 boys) for the CM-Avoid group. The patients' median ages at the start of the observation period were 7.5 years (6.1-9.6) for boys and 6.8 years (5.8-7.8) for girls in the CM-OIT group, and 5.4 years (5.0-7.5) for boys and 5.7 years (5.0-7.1) for girls in the CM-Avoid group. The initial HtSDS in the CM-OIT group was -0.31 (median) and increased to -0.22 (median) after OIT (p = 0.016). In contrast, there was no significant change in HtSDS for the CM-Avoid group.

Conclusions: Physical growth of pediatric patients with severe CM allergies, who have avoided CM completely, could be improved by OIT for CM allergy.