{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:50:22Z","timestamp":1782276622399,"version":"3.54.5"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:p>Cow\u2019s milk allergy (CMA) is among the most common food allergies in early childhood, affecting approximately 2\u20133% of children under 3\u202fyears of age. Management requires strict elimination of cow\u2019s milk and dairy products, typically replaced with hypoallergenic formulas. Although essential, this dietary restriction may predispose infants\u2014particularly during the first 2\u202fyears of life\u2014to nutritional imbalances. This mini review synthesizes current evidence on micronutrient status and growth outcomes in children with CMA, with emphasis on the impact of dietary management. Across observational studies, vitamin D inadequacy is the most consistently reported abnormality, with insufficiency affecting approximately 30\u201355% of children and deficiency around 20\u201325%. Iron deficiency is also frequent, including both overt anemia and subclinical depletion. Lower levels of calcium, vitamin B12, and iodine have been described, generally within reference ranges but suggestive of suboptimal intake. Growth impairment is commonly observed at diagnosis, particularly affecting weight more than linear growth. Appropriate nutritional management, including the use of hypoallergenic formulas (HF) and dietary counselling, is associated with significant catch-up growth. However, an increased risk of being overweight has been reported during follow-up, highlighting the need for balanced nutritional strategies. Key risk factors for nutritional compromise include multiple food allergies, prolonged dietary restriction without adequate substitution, poor adherence to supplementation, and restrictive maternal diets during breastfeeding. Overall, CMA management should extend beyond allergen avoidance to include proactive nutritional surveillance, targeted supplementation, and individualized dietary planning to support optimal growth and long-term health.<\/jats:p>","DOI":"10.3389\/fnut.2026.1886883","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:44:42Z","timestamp":1782276282000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Micronutrient status and growth outcomes in children with cow\u2019s milk allergy: beyond elimination diets"],"prefix":"10.3389","volume":"13","author":[{"given":"Mariano","family":"Di Rosa","sequence":"first","affiliation":[{"name":"Pediatric Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia","place":["Pavia, Italy"]},{"name":"Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Foti Randazzese","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia","place":["Pavia, Italy"]},{"name":"Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"De Amici","sequence":"additional","affiliation":[{"name":"Immuno-Allergology Laboratory of Clinical Chemistry and Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele Giovanni","family":"Ghiglioni","sequence":"additional","affiliation":[{"name":"SC Pediatria Pneumoinfettivologia, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Marseglia","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Luigi","family":"Marseglia","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Verduci","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Milan","place":["Milan, Italy"]},{"name":"Pediatric Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Licari","sequence":"additional","affiliation":[{"name":"Pediatric Unit, 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