A Preterm Case of Cow's Milk Allergy Presenting with Recurrent Ascites Treated with Donor Breast Milk

Area of Science:

• Neonatal Medicine
• Pediatric Allergy
• Gastroenterology

Background:

• Cow's milk allergy (CMA) is a common concern in infants.
• Preterm infants are at increased risk for various feeding complications.
• Early diagnosis and management of CMA are crucial for infant health.

Observation:

• A preterm male infant born at 24 weeks' gestation developed recurrent ascites, abdominal distention, and edema.
• Symptoms emerged after the introduction of various infant formulas (soy, casein-hydrolyzed) due to insufficient maternal lactation.
• Clinical improvement was observed upon exclusive breastfeeding.

Findings:

• The infant was diagnosed with cow's milk allergy based on symptom resolution with breastfeeding.
• The use of donated breast milk in combination with mother's own milk prevented symptom recurrence.
• Ascites is identified as a potential clinical manifestation of neonatal cow's milk allergy.

Implications:

• Neonatal ascites should be considered a possible symptom of cow's milk allergy.
• Donated breast milk offers a viable therapeutic option for managing CMA in preterm infants when maternal milk is insufficient.
• This case underscores the importance of considering CMA in the differential diagnosis of abdominal symptoms in preterm neonates.