Alternatives to cow’s milk and soy milk are
often necessary for children with food allergies. Although
hydrolyzed and elemental formulas are appropriate
replacements, other milk products such as rice and almond
milk are insufficient protein sources for children under 2 years
of age. A chart review on three patients treated for protein
malnutrition in association with multiple diagnosed food
allergies that resulted in refractory eczema revealed adverse
outcomes that resulted from elimination diets. The use of rice
milk resulted in hypoalbuminemia and poor weight gain in
all cases, and multiple secondary infections in one patient.
These cases illustrate the need for careful nutritional guidance
in the management of food allergy, as well as the importance
of cautious use and interpretation of testing for food allergies
in the absence of a clear clinical history of reaction.