Improving Nutrient Intake and Growth in Children With Multiple Food Allergies

• Growth [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  Weight for age, lenght/height for age, and weight for length/height z-scores will be assessed. Growth will be compared to reference standards. Growth velocity will be calculated in grams/day.
  
  

• Nutrient intake [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  Changes in nutrient intake will be assessed using a multiple-pass 24 hour recalls administered at 4 times throughout the 6 month study period. Nutrient intake will be compared with the DRI and changes in nutrient intake over time will be assessed. The primary goal is to assess changes in nutrient intake before and after nutrition intervention.
  
  

This is a prospective observational study with repeated measure design. All participants aged 6 months to 6 years diagnosed with two or more food allergies at Children's Hospital of Wisconsin Asthma, Allergy, & Immunology clinic will be invited to participate in the research study. At least one of the two food allergies must be milk, egg, wheat, or soy, which are nutritionally important food allergies. There will be no control group recruited for the study as comparisons will be made within the study population.

Upon diagnosis of multiple food allergies, subjects will be enrolled and consent will be obtained. Height, weight, and head circumference will be measured and recorded using standard procedures. The Mealtime Behavior Questionnaire (MBQ) and Feeding Strategies Questionnaire (FSQ) will be filled out by the parent or guardian. On the same day as diagnosis, a registered dietitian will call the family to complete a multiple-pass 24-hour diet recall over the phone (Johnson, Driscoll, & Goran, 1996).

At the initial visit with the dietitian, which will occur within one month of diagnosis, demographic data and medical history will be obtained. A multiple-pass 24-hour recall will be completed. The participant's parent or guardian will again complete the MBQ and FSQ. In addition, they will receive standardized nutrition intervention to include nutrition assessment, food allergy education, and general nutrition education.

Three months and six months after diagnosis, the participant will attend a second and third visit with the dietitian. Height, weight, and head circumference will be measured and recorded using standard procedures. A multiple-pass 24-hour recall will be completed. The participant's parent or guardian will complete the MBQ and FSQ. Follow-up nutrition intervention will include nutrition reassessment, food allergy education as needed, and general nutrition education as needed.

All aspects of this study, with the exception of the MBQ and FSQ, are the current standard of care in the Asthma, Allergy, and Immunology clinic for patients with multiple food allergies.