Fatores associados e repercussões nutricionais do desmame em lactentes com alergia ao leite de vaca: estudo de coorte

Abstract

Objective: To analyze the associated factors and nutritional repercussions of weaning in infants with cow's milk allergy (CMA) assisted at the Sergipe Food Allergy Center. Method: Prospective cohort study, with a case group (children with CMA) and two control groups (symptomatic non-allergic/CS and asymptomatic/CA children). At the beginning of the study, 166 children made up the total number of volunteers, of which 30 children made up the ALV group, 84 the CS group and 52 the CA group. At the end of the study, the CMA group continued with 30 children, the CS group with 41 and the CA group with 23 children. Socioeconomic, anthropometric, breastfeeding data, utensils for offering infant formula and the factors that motivated weaning were collected from the maternal perspective. Survival Analysis was performed to compare breastfeeding time between the three study groups and a Linear Regression model was performed to verify the factors associated with breastfeeding time. Results: At the beginning of the study, 33.3% of children in the CMA group, 17.1% in the CS group and 69.6% in the CA group were exclusively breastfed (p=0.005). The most common factors for weaning in children with CMA were the cow's milk elimination diet (30%), allergic symptoms in the child (20%) and breast engorgement (20%). Children who used a cup as a means of offering infant formula spent 279 more days breastfeeding compared to those who used a bottle (Bstd=1.38; p=0.029). Of the total number of children assessed, 2.1% were short (HAZ ˂ -2) and 3.2% were overweight for their age (WAZ > 2) at the beginning of the study. Vitamin D showed lower serum concentrations the longer the child continued breastfeeding. Conclusion: Children with CMA and non-allergic gastrointestinal complaints weaned earlier compared to asymptomatic children. The main causes of weaning in CMA children were: difficulty adhering to the elimination diet, breast engorgement and allergic reactions in children. Using a sippy cup was the main factor associated with longer breastfeeding duration. The nutritional profile did not vary significantly according to the duration of breastfeeding, with the exception of vitamin D.