Growth Assessment in Infants with Cow Milk Protein Allergy, Amino Acid Fed Formula versus Breast Milk Fed with Maternal Dairy Product Restriction

Background: Cow's milk protein allergy (CMPA) is an immune-mediated hypersensitivity in infants, often diagnosed through symptoms affecting multiple organ systems. Accurate diagnosis and management are crucial for infant growth and development. Objective: This study aimed to compare growth outcomes, symptom improvement, and clinical signs between infants with CMPA fed amino acid-based formula (AAF) versus those exclusively breastfed with maternal cow's milk protein elimination. Patients and methods: A retrospective cohort study was conducted at the Outpatient Gastroenterology Clinic, Abu Al-Rish Hospital, Cairo University, from July 2021 to July 2022. 54 infants with CMPA, diagnosed based on clinical symptoms, were divided into two equal groups: Group A (exclusive breastfeeding with maternal dietary restrictions) and group B (AAF). Data on demographics, allergy history, symptoms, and clinical assessments were collected at baseline, 3, 6, and 12 months. Results: No significant differences were found between groups in demographic data (p > 0.05). The most common symptoms at baseline were abdominal distension (92.6%), diarrhea (74.1%), and vomiting (66.7%). After 3 months, both groups showed significant symptom improvement (p < 0.05), with no symptoms of diarrhea or vomiting in either group at 12 months. Growth parameters improved significantly in both groups (p < 0.05). The z-scores for weight-for-age, length-for-age, and weight-for-length showed significant improvements over time in both groups. Conclusion: Both breastfeeding with maternal elimination diets and AAF provide effective management for CMPA. However, AAF may offer superior growth outcomes and symptom control in severe cases. Further studies are required to refine management guidelines for CMPA.