title: Cow's milk allergy in children: adherence to a therapeutic elimination diet and reintroduction of milk into the diet.
abstract: OBJECTIVE
  The basic treatment for cow's milk allergy (CMA) is the elimination of all cow's milk proteins (CMP) from the diet. This study aimed at characterizing the diet of children with a diagnosis of CMA, to assess the degree of adherence to the elimination diet and to evaluate the factors associated with the adherence and age of recovery.
  
  
  METHODS
  From a birth cohort study, food records of 267 children diagnosed with CMA were studied to define how strictly the elimination diet was adhered to. Subsequent food records were studied to assess the age at reintroduction of milk products in the child's diet.
  
  
  RESULTS
  The families adhered to the elimination diet of the child with extreme accuracy in 85% of the cases. Older and monosensitized children had more often small amounts of CMP in their diet, possibly because of the absence of nutritional information by a dietitian/nutritionist. Adherence to the diet was neither related to any other sociodemographic factor studied nor to the age at reintroduction of milk products into the diet.
  
  
  CONCLUSIONS
  The therapeutic elimination diet of children diagnosed with CMA was well adhered to. Low intakes of vitamin D, calcium, and riboflavin are of concern in children who follow or have followed a cow's milk-free diet.
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland. jetta.tuokkola@iki.fi
authors.forename: J
authors.initials: J
authors.lastname: Tuokkola
authors.forename: M
authors.initials: M
authors.lastname: Kaila
authors.forename: C
authors.initials: C
authors.lastname: Kronberg-Kippilä
authors.forename: H K
authors.initials: HK
authors.lastname: Sinkko
authors.forename: T
authors.initials: T
authors.lastname: Klaukka
authors.forename: P
authors.initials: P
authors.lastname: Pietinen
authors.forename: R
authors.initials: R
authors.lastname: Veijola
authors.forename: O
authors.initials: O
authors.lastname: Simell
authors.forename: J
authors.initials: J
authors.lastname: Ilonen
authors.forename: M
authors.initials: M
authors.lastname: Knip
authors.forename: S M
authors.initials: SM
authors.lastname: Virtanen
mesh_terms: D000818:Animals; D002611:Cheese; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D015331:Cohort Studies; D004032:Diet; D015930:Diet Records; D005190:Family; D005260:Female; D005387:Finland; D006801:Humans; D007223:Infant; D041943:Infant Formula; D008297:Male; D008892:Milk / Q000009:adverse effects; D016269:Milk Hypersensitivity / Q000178:diet therapy* / Q000503:physiopathology; D008894:Milk Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D010349:Patient Compliance / Q000706:statistics & numerical data*; D015014:Yogurt
chemical_list: D008894:Milk Proteins