Background and aims Cow′s milk proteins allergy is the most common type of allergy in infants. The aims of the study were to assess the nutritional status on infants diagnosed by cow’s milk allergy and the benefits of nutritional intervention on infants growth.

Methods A prospective study on a sample of 32 infants aged 3 to 12 months diagnosed with cow’s milk allergy from 2014–2016 was conducted. The following data were analysed: type of feeding, family history of atopy, age at onset of suggestive symptoms and specific serum IgE values. For the assessment of nutritional status, all the analyses were performed based on the z-score weight for age, height for age and weight for height. Body weight and length were assessed at the time of diagnosis and 6 months of nutritional intervention with monthly intervals of evaluation.

Results The sample included predominantly girls with a mean age of 7.2 months. The average age at onset of symptoms was 2.20±2.48 months. Approximately one-half of the infants were younger than 6 months of age. Family history for atopy was positive in 18 patients (56.2%). Exclusive gastrointestinal symptoms were observed in 14 patients (43.7%), cutaneous manifestations in 10 patients (31.3%), respiratory symptoms in 4 patients (12.5%) and systemic symptoms in 4 patients (12.5%). Specific IgE profile reported to 47.3% of the study sample the IgE mediated allergy forms. The assessment of the nutritional status at the time of diagnosis demonstrated that 26.2% had a deficit in weight-for-age, 10% had a deficit in weight-for-height and 16.3% had a deficit in height-for-age z score. At the time of diagnosis 47.5% of the infants were of normal weight for age. Extensively hydrolyzed formulas were recommended for 56.2% (18/32) of patients and amino acid-based formulas for 43.8% (14/32) of patients. At the end of six months of nutritional intervention data indicated that 8.5% had maintained weight-for-age deficit, 6.4% had a deficit in weight-for-height and 11.2% had a deficit in height-for-age z score.

Conclusions The weight-for-age deficit was the most predominant indicator of nutritional status in infants affected by cow’s milk allergy. Highly effective replacement diets are needed to control symptoms and promote nutritional recovery in order to avoid malnutrition.