Growth trajectories in exclusively breastfed infants with clinically diagnosed food allergy: a prospective longitudinal cohort study
- 1Department of Growth, Development and Mental Health of Children and Adolescence Center of Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents' Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders. Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
- 2Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
Abstract
BackgroundFood allergy (FA) in infancy may be accompanied by feeding difficulties and dietary modifications during breastfeeding, which may influence early growth. However, longitudinal growth patterns in exclusively breastfed infants with clinically diagnosed FA remain incompletely characterized.MethodsIn this prospective longitudinal cohort study, 73 exclusively breastfed infants (30 with FA and 43 without FA) were enrolled at 4–6 months of age and followed through infancy. A total of 268 anthropometric observations were included in the longitudinal analysis. Weight-for-length Z-score (WLZ), weight-for-age Z-score (WAZ), length-for-age Z-score (LAZ), and head circumference-for-age Z-score (HCZ) were calculated according to the WHO Child Growth Standards. Growth trajectories were evaluated using linear mixed-effects models with infant-specific random intercepts. Age was modeled continuously and centered at 5 months. Sensitivity analyses examined nonlinear age effects and group-by-sex interactions.ResultsMaternal dietary avoidance was substantially more common among mothers of infants with FA than among those without FA (83.3% vs. 18.6%, p < 0.001). In the longitudinal WLZ model, the estimated difference between the NFA and FA groups at 5 months was 0.423 Z-score units (95% CI 0.036 to 0.811, p = 0.035), with lower estimated WLZ in the FA group. There was no evidence of a group-by-age interaction (estimate = −0.011, 95% CI − 0.086 to 0.063, p = 0.763), indicating no detectable difference in the linear rate of WLZ change between groups. Sensitivity analysis did not support a nonlinear WLZ trajectory, and no group-by-sex interaction was detected.ConclusionInfants with clinically diagnosed FA had lower estimated WLZ around 5 months of age than infants without FA, but the longitudinal analysis did not provide evidence that WLZ changed at a different linear rate between groups over time. Maternal dietary avoidance was substantially more common among mothers of infants with FA, underscoring the importance of appropriate nutritional counseling and growth monitoring in this population.
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BibTeX
@article{fang2026growth,
title = {{Growth trajectories in exclusively breastfed infants with clinically diagnosed food allergy: a prospective longitudinal cohort study}},
author = {Jun Fang and Jun Fang and Zhanzhan Zhang and Zhanzhan Zhang and Yuanfeng Zhong and Yuanfeng Zhong and Yannan Wan and Yannan Wan and Qian Chen and Qian Chen and Xuelin Xia and Xuelin Xia and Xuan Zhang and Xuan Zhang},
journal = {Frontiers in Nutrition},
year = {2026},
month = oct,
doi = {10.3389/fnut.2026.1924841},
url = {https://doi.org/10.3389/fnut.2026.1924841},
note = {CC BY},
}
RIS
TY - JOUR
TI - Growth trajectories in exclusively breastfed infants with clinically diagnosed food allergy: a prospective longitudinal cohort study
AU - Jun Fang
AU - Jun Fang
AU - Zhanzhan Zhang
AU - Zhanzhan Zhang
AU - Yuanfeng Zhong
AU - Yuanfeng Zhong
AU - Yannan Wan
AU - Yannan Wan
AU - Qian Chen
AU - Qian Chen
AU - Xuelin Xia
AU - Xuelin Xia
AU - Xuan Zhang
AU - Xuan Zhang
PY - 2026
DA - 2026/10/23
JO - Frontiers in Nutrition
DO - 10.3389/fnut.2026.1924841
UR - https://doi.org/10.3389/fnut.2026.1924841
AB - BackgroundFood allergy (FA) in infancy may be accompanied by feeding difficulties and dietary modifications during breastfeeding, which may influence early growth. However, longitudinal growth patterns in exclusively breastfed infants with clinically diagnosed FA remain incompletely characterized.MethodsIn this prospective longitudinal cohort study, 73 exclusively breastfed infants (30 with FA and 43 without FA) were enrolled at 4–6 months of age and followed through infancy. A total of 268 anthropometric observations were included in the longitudinal analysis. Weight-for-length Z-score (WLZ), weight-for-age Z-score (WAZ), length-for-age Z-score (LAZ), and head circumference-for-age Z-score (HCZ) were calculated according to the WHO Child Growth Standards. Growth trajectories were evaluated using linear mixed-effects models with infant-specific random intercepts. Age was modeled continuously and centered at 5 months. Sensitivity analyses examined nonlinear age effects and group-by-sex interactions.ResultsMaternal dietary avoidance was substantially more common among mothers of infants with FA than among those without FA (83.3% vs. 18.6%, p < 0.001). In the longitudinal WLZ model, the estimated difference between the NFA and FA groups at 5 months was 0.423 Z-score units (95% CI 0.036 to 0.811, p = 0.035), with lower estimated WLZ in the FA group. There was no evidence of a group-by-age interaction (estimate = −0.011, 95% CI − 0.086 to 0.063, p = 0.763), indicating no detectable difference in the linear rate of WLZ change between groups. Sensitivity analysis did not support a nonlinear WLZ trajectory, and no group-by-sex interaction was detected.ConclusionInfants with clinically diagnosed FA had lower estimated WLZ around 5 months of age than infants without FA, but the longitudinal analysis did not provide evidence that WLZ changed at a different linear rate between groups over time. Maternal dietary avoidance was substantially more common among mothers of infants with FA, underscoring the importance of appropriate nutritional counseling and growth monitoring in this population.
SN - 2296-861X
ER -