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Cow's milk and intestinal blood loss in late infancy
E E Ziegler1, T Jiang, E Romero
1Fomon Infant Nutrition Unit, Department of Pediatrics, University of Iowa, Iowa City 52242, USA.
Insights
Cow's milk causes intestinal blood loss in 7.5-month-old infants, but this effect diminishes by 12 months. This suggests infant gut sensitivity to cow's milk decreases with age.
Area of Science:
- Pediatric Gastroenterology
- Infant Nutrition
- Clinical Research
Background:
- Cow's milk is a common infant food, but can cause occult intestinal blood loss in younger infants.
- The prevalence of cow's milk-induced intestinal blood loss in older infants is less understood.
Purpose of the Study:
- To investigate intestinal blood loss in response to cow's milk feeding in 7.5-month-old and 12-month-old infants.
- To determine the age-related changes in infant gastrointestinal response to cow's milk.
Main Methods:
- A cohort of 62 infants were fed formula, then pasteurized cow's milk.
- Stool hemoglobin concentration was quantitatively measured.
- Iron nutritional status was assessed in all infants.
Main Results:
- Infants fed cow's milk from 7.5 months showed increased stool hemoglobin, particularly those previously breastfed.
- No significant increase in stool hemoglobin was observed in 12-month-old infants fed cow's milk.
- Cow's milk consumption did not impact iron nutritional status in either age group.
Conclusions:
- Infant gastrointestinal tract responsiveness to cow's milk is attenuated by 7.5 months and absent by 12 months.
- The study highlights a natural decrease in infant gut sensitivity to cow's milk as they age.
Objectives:
Young infants commonly show occult intestinal blood loss when fed cow's milk, but in older infants blood loss may be less common. This study examined intestinal blood loss in response to cow's milk feeding in normal 7(1/2)-month-old and 12-month-old infants.
Study Design:
Infants (n = 62) were fed formula for 1 month and then pasteurized cow's milk for 2 months. Stools were collected for quantitative determination of hemoglobin. Iron nutritional status was assessed.
Results:
Infants fed cow's milk from 7(1/2) months of age showed a significant increase in guaiac-positive stools and in stool hemoglobin concentration. These effects were largely limited to those infants who had been breast fed early in life. Infants fed cow's milk from 12 months of age at baseline had greater stool hemoglobin concentrations than 7(1/2)-month-old infants, but cow's milk produced no significant increase. In neither age group did cow's milk affect iron nutritional status.
Conclusion:
The response to cow's milk is attenuated in infants aged 7(1/2) months compared with younger infants. By 12 months of age, the response has disappeared entirely. We conclude that the gastrointestinal tract of healthy infants gradually loses its responsiveness to cow's milk.