PURPOSE OF THE STUDY.
To investigate whether some infants with milk protein intolerance become tolerant sooner than 12 months of age.
Infants <4 months of age (N = 16) receiving breast milk (n = 1) or a cow’s-milk (n = 2) or casein hydrolysate (n = 13) formula who presented to a pediatric gastroenterology practice during an 18-month period and had a positive stool guaiac test. Exclusion criteria included iron supplementation and or conditions such as anal fissure, infection, enterocolitis, and history of intestinal surgery.
Parents submitted stool specimens on guaiac cards once weekly. After demonstrating guaiac-negative stools for at least 2 consecutive months on a casein hydrolysate or amino acid formula, infants in this prospective, longitudinal cohort study were rechallenged with their prestudy formula.
By age 7 months, milk protein intolerance was resolved in 12 of 16 of infants, the remainder having resolved by 10 months. The average age of resolution was 6.7 ± 1.0 months (mean ± SD).
It may be reasonable to treat infants with milk protein intolerance for 2 to 3 months with a hypoallergenic formula and rechallenge them at 6 months of age. Rechallenging before 12 months could result in significant cost savings.
This was a rather small study, but it challenges the practice of delaying reintroduction of a milk- or soy-based formula (or beverage) in infants with benign proctocolitis until 12 months of age.
- Copyright © 2015 by the American Academy of Pediatrics