Breastfeeding in the treatment of children with phenylketonuria
Kanufre, V.C.; Starling, A.L.P.; Leão, E.; Aguiar, M.J.B.; Santos, J.S.; Soares, Rângelis.D.L.; Silveira, A.M.
Jornal de Pediatria 83(5): 447-452
2007
ISSN/ISBN: 0021-7557 PMID: 17676249 Document Number: 198201
Objective: To evaluate the effect of breastmilk as a source of phenylalanine (phe) on the levels of this amino acid and on growth in phenylketonuric infants. Methods: The study recruited 35 breastfed phenylketonuric infants (born between January 2000 and April 2005) being treated at the Special Genetics Service, Hospital das Clinicas, Universidade Federal de Minas Gerais, Minas Gerais, Brazil, and compared their results with those of 35 infants fed on commercial, milk-based formula. The groups were paired for sex and age at weaning from breastfeeding. Data were analysed up until cessation of breastmilk or for 12 months follow-up. The breastfed group was given a "special formula" free of phe by bottle every 3 h and breastmilk at will during the intervals. The levels of phe in blood collected weekly up to 6 months and fortnightly up to one year de age were analysed while breastfeeding continued. The 2 groups were compared in terms of the time taken for the levels of phe in blood to return to normal after treatment was started using the Wilcoxon test. Anthropometric data were compared with Student's t paired test in the form of z scores. The phe assays were analysed throughout breastfeeding. Results: The median time taken for phe levels to return to normal was 8 days for the breastfed group and 7 days for the control group. The phe assay results were normal in 87% of tests for the breastfed group and in 74.4% for the control group. The majority of children in both groups exhibited a z score > -2 on anthropometric examination. Conclusions: Continuation of breastfeeding during treatment is adequate for metabolic control and growth in children with phenylketonuria.