Cow milk protein allergy presenting as feeding intolerance and eosinophilia: case reports of three preterm neonates

Area of Science:

• Neonatology
• Pediatric Allergy
• Gastroenterology

Background:

• Cow milk protein allergy (CMPA) is a common concern in infants.
• Preterm infants are a vulnerable population with unique medical challenges.
• Feeding intolerance and eosinophilia are potential indicators of adverse reactions in neonates.

Observation:

• Three preterm infants experienced feeding intolerance, sepsis-like episodes, and significant eosinophilia.
• These symptoms were associated with exposure to cow milk-based formulas.
• Clinical improvement was observed upon the removal of cow milk from the infants' diets.

Findings:

• Cow milk protein allergy (CMPA) can manifest with significant clinical symptoms in preterm infants.
• Feeding intolerance and persistent eosinophilia are key signs of CMPA in this population.
• Dietary elimination of cow milk is an effective intervention for CMPA.

Implications:

• CMPA should be considered in the differential diagnosis of sick preterm infants presenting with feeding intolerance and eosinophilia.
• Early identification and management of CMPA can improve clinical outcomes in preterm neonates.
• This case series underscores the importance of considering specific food allergies in neonatal care.