Poor growth in multi-ethnic children with food allergy in Amsterdam.

BACKGROUND: Growth faltering is commonly reported in children with food allergy (FA), potentially due to nutrient deficiencies and/ or underlying pathophysiology. AIMS: To study growth in Dutch food-allergic children, focusing on Height-for-Age Z-scores (HAZ), Weight-for-Age Z-scores (WAZ), and BMI (Body Mass Index)-for-Age Z-scores (BAZ) and identify predictive factors for growth. METHODS: We conducted a mono-centre study in 114 children, aged 0.5-18 years from diverse ethnic backgrounds, diagnosed with FA at OLVG Hospital (2021-2022). Data were collected from medical records and interviews. Z-scores were calculated using Growth Analyzer and WHO software and compared to the Dutch growth references and WHO growth standards, using one proportion Z-tests. Predictive factors for growth were identified using multivariable linear regression analyses. Retrospectively collected growth trajectories of 89 children were analyzed using linear mixed models. RESULTS: When using Dutch growth references in this cohort (median age 31.16 months), stunting (HAZ <-2) was observed in 6.1% (p = .03) where 2.5% was expected. HAZ and WAZ <-1 were found in 28.1% (p < .01) and 29.2% (p < .01), respectively, where 15.9% was expected. Compared to the Dutch growth references, WHO growth standards more frequently identify adequate growth. Having asthma and non-IgE-mediated cow's milk allergy (CMA) was associated with a lower WAZ and BMI. HAZ deteriorated from 5 to 11 months onwards, stabilizing around age three. CONCLUSIONS: Children with FA, particularly those with asthma and non-IgE-mediated CMA, had lower Z-scores for BMI and weight as compared to Dutch growth references. Length gradually deteriorated from 5 to 11 months onwards, which stabilized around age three.