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Cow's milk associated rectal bleeding: a population based prospective study

Arnon Elizur1, Michal Cohen, Michael R Goldberg

  • 1Department of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel. elizura@gmail.com

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|October 12, 2012
PubMed

Insights

Isolated rectal bleeding in infants due to cow's milk protein allergy is rare, affecting 0.16% of infants. This condition is typically benign and resolves with dietary changes, with reintroduction of cow's milk often well-tolerated.

Area of Science:

  • Pediatric Gastroenterology
  • Allergy and Immunology
  • Clinical Nutrition

Background:

  • Isolated rectal bleeding in infants is commonly linked to cow's milk consumption.
  • The exact prevalence, diagnostic approaches, and management strategies for this condition remain debated.

Purpose of the Study:

  • To determine the prevalence of isolated rectal bleeding attributed to cow's milk protein in infants.
  • To evaluate diagnostic methods and management strategies, including dietary elimination and reintroduction of cow's milk protein.

Main Methods:

  • A prospective, population-based study followed 13,019 infants from birth.
  • 21 infants with isolated rectal bleeding due to cow's milk protein were identified and managed.
  • Infants were followed for symptom recurrence after dietary modifications and compared to a control group.

Main Results:

  • The prevalence of isolated rectal bleeding attributed to cow's milk was found to be 0.16%.
  • All infants became asymptomatic within days of dietary modifications.
  • Reintroduction of cow's milk protein was tolerated by 78.5% of infants, with no significant difference in 1-year hemoglobin levels compared to those on elimination diets.

Conclusions:

  • Isolated rectal bleeding attributed to cow's milk protein is a low-prevalence, generally benign condition.
  • Dietary elimination is effective for symptom resolution, and reintroduction of cow's milk is often well-tolerated.
  • Reintroducing cow's milk protein is recommended to confirm diagnosis and prevent unnecessary prolonged elimination diets.
Abstract

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