Refractory proctocolitis in the exclusively breast-fed infants

Area of Science:

• Pediatrics
• Allergy and Immunology
• Gastroenterology

Background:

• Cow's milk protein allergy is a common concern in infants.
• Allergic proctocolitis presents as rectal bleeding in exclusively breast-fed infants (1-6 months).
• Cow's milk protein can transfer through breast milk, triggering allergic reactions.

Purpose of the Study:

• To guide pediatricians and primary care physicians in diagnosing cow's milk protein allergy.
• To provide management strategies for exclusively breast-fed infants with this allergy.
• To clarify the link between maternal diet and infant allergic proctocolitis.

Main Methods:

• Clinical feature assessment for diagnosis.
• Dietetic therapy (maternal cow's milk avoidance) as a diagnostic and therapeutic tool.
• Monitoring infant response to dietary changes.

Main Results:

• Rectal bleeding in infants is often linked to cow's milk protein exposure via breast milk.
• Maternal avoidance of cow's milk protein leads to symptom resolution within 72-96 hours.
• The majority of affected infants can tolerate cow's milk by their first birthday.

Conclusions:

• Cow's milk protein allergy is a manageable cause of rectal bleeding in breast-fed infants.
• Diagnosis relies on clinical presentation and response to dietary intervention.
• Early identification and management improve infant outcomes and support continued breastfeeding.