Solid-food introduction in infants diagnosed as having a cow's-milk protein-induced enterocolitis

In a prior retrospective analysis of 32 infants diagnosed with cow's-milk protein-induced enterocolitis (CMPIE), gastrointestinal (GI) symptoms were observed with the introduction of milk-free infant cereal. The aim of this randomized controlled trial was to compare the incidence of new GI symptoms with the introduction of either milk-free infant rice cereal or carrots as the first complementary food at 6 months of age in infants previously diagnosed as having CMPIE.

Thirty-nine infants were enrolled in the study. Twenty were randomized to start with pureed carrots and 19 were randomized to start with milk-free infant rice cereal. GI signs and symptoms developing within 2 weeks were recorded.

No significant differences were noticed in the incidence of new GI symptoms and the change in the frequency of GI symptoms upon solid-food introduction, whether it was carrots or milk-free infant rice cereal. A high overall incidence rate (47%) of new GI symptoms was observed in the whole cohort. The mean number of days for onset of new symptoms was 6. The most common GI signs and symptoms observed were related to alteration of stool characteristics. Breast-feeding was not shown to have a protective effect on the development of new GI symptoms during solid-food introduction.

Many infants with CMPIE will develop GI signs and symptoms following the introduction of solid food, whether milk-free infant rice cereal or carrots are introduced, and their onset may be delayed.