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Published on: February 15, 2018
[Hemorrhagic colitis in exclusively breast-fed infants]
S Sorea1, A Dabadie, L Bridoux-Henno
1Département de médecine de l'enfant et de l'adolescent, hôpital Sud, 16, boulevard de Bulgarie, 35056 Rennes cedex, France.
Insights
Infants with rectal bleeding while exclusively breast-fed may have food allergies. Excluding cow's milk protein from the mother's diet resolved symptoms in most cases, indicating a simple resolution for infant proctocolitis.
Area of Science:
- Pediatric Gastroenterology
- Allergy and Immunology
Background:
- Presents clinical, biological, and endoscopic data of six infants under 3 months old experiencing bloody stools.
- All infants were exclusively breast-fed at the time of symptom onset.
Purpose of the Study:
- To investigate the potential role of food allergy in exclusively breast-fed infants presenting with rectal bleeding.
- To evaluate the efficacy of dietary interventions in managing infant proctocolitis.
Main Methods:
- Six infants (2 female, 4 male) aged 1-2 months with recurrent rectal bleeding underwent fiberoptic rectosigmoidoscopy.
- Histopathological examination of rectal biopsies was performed.
- Maternal dietary exclusion of cow's milk protein and infant weaning protocols were implemented.
Main Results:
- Rectosigmoidoscopy revealed mucosal congestion, petechiae, and ecchymoses in all cases.
- Histopathology showed eosinophilic infiltrates in 5 out of 5 infants with rectal biopsies.
- Five infants improved after maternal cow's milk protein exclusion; one improved after weaning.
Conclusions:
- Food allergy should be considered in the differential diagnosis of proctocolitis, even in exclusively breast-fed infants.
- Dietary modifications, particularly maternal exclusion of cow's milk protein, are effective in managing this condition.
Introduction:
Authors report clinical, biological and endoscopic data of six children aged less 3 months with bloody stools while they were exclusively breast-fed.
Results:
Two girls and four boys aged 1 to 2 months presented with isolated but recurrent rectal bleeding. All were explored by fiberoptic rectosigmoidoscopy between 1 and 3,2 months. Macroscopic aspects were congestion (6 cases), petechial and ecchymotic (4 cases), with normal mucosal areas (5 cases). Histopathology showed eosinophilic infiltrates in all 5 children with rectal biopsy. Evolution was satisfactory after cow's milk protein exclusion in maternal diet for five children and after weaning in 1. All children were weaned with protein hydrolysate. Cow's milk protein were later introduced without adverse reactions at 6 to 23 months.
Conclusion:
Food allergy can be considered in proctocolitis including exclusive breast-fed children. Evolution after maternal diet is, as usual, simple.
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