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Severe cow's milk protein allergy in a Chinese neonate
1Paediatric Department, Tuen Mun Hospital, Tsing Chung Koon Road, Tuen Mun, Hong Kong.
Insights
Cow's milk protein allergy can cause severe infant issues like growth failure and diarrhea. Early diagnosis and elemental formula can lead to rapid recovery, highlighting the importance of prompt intervention.
Area of Science:
- Pediatrics
- Allergology
- Gastroenterology
Background:
- Cow's milk protein allergy (CMPA) is an increasing concern in developed nations.
- Infant feeding practices and early childhood nutrition are critical areas of study.
Observation:
- A Chinese infant presented with severe failure to thrive, chronic diarrhea, and metabolic acidosis at 28 days old.
- Clinical symptoms strongly suggested CMPA.
Findings:
- Diagnostic withdrawal and reintroduction of cow's milk formula confirmed CMPA.
- Transitioning to an elemental infant formula resolved metabolic acidosis and diarrhea.
- The infant demonstrated significant catch-up growth after dietary changes.
Implications:
- Early identification and management of CMPA are crucial for preventing severe complications.
- Prompt treatment can lead to rapid resolution of symptoms and promote healthy infant development.
- Awareness of potential later atopic manifestations following CMPA is important for long-term infant health monitoring.
Abstract:
Cow's milk protein allergy is a growing problem in developed countries. We report the case of a Chinese infant, born at term, who presented on day 28 with severe growth failure, chronic diarrhoea, and metabolic acidosis. Investigations supported a diagnosis of cow's milk protein allergy. This was confirmed by withdrawing and reintroducing the relevant infant formula under controlled clinical conditions. Both acidosis and diarrhoea were seen to resolve, and 'catch-up' growth was evident after introduction of an elemental infant formula. Early recognition of this problem leads to a rapid 'cure', as seen in this case. However, later presentation with other atopic conditions has been reported.