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Updated: Feb 22, 2026

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[Rectal bleeding in infancy; could it be an allergy?]

Anuradha S Ter Haar1,2, Hans de Groot1

  • 1Reinier de Graaf Groep, Delfts Allergie Centrum, Delft.

Nederlands Tijdschrift Voor Geneeskunde
|February 20, 2026
PubMed

Insights

Rectal bleeding in infants can stem from ingested maternal blood or Food Protein-Induced Allergic Proctocolitis (FPIAP) from cow's milk. FPIAP is a non-IgE-mediated allergy that resolves with diet changes, offering a favorable prognosis.

Area of Science:

  • Pediatric Gastroenterology
  • Allergy Immunology

Background:

  • Rectal bleeding in infants is a common concern for parents and clinicians.
  • Differentiating benign causes from allergic reactions is crucial for appropriate management.

Purpose of the Study:

  • To highlight two distinct causes of rectal bleeding in infants: ingested maternal blood and Food Protein-Induced Allergic Proctocolitis (FPIAP).
  • To emphasize the diagnostic approach and favorable prognosis of FPIAP.

Main Methods:

  • Case report review of two infants presenting with rectal bleeding.
  • Clinical evaluation, diagnostic workup, and treatment initiation.

Main Results:

  • One infant diagnosed with ingested maternal blood.
  • The second infant diagnosed with Food Protein-Induced Allergic Proctocolitis (FPIAP) triggered by cow's milk exposure.
  • Symptoms resolved in the FPIAP case after maternal cow's milk elimination diet.

Conclusions:

  • Rectal bleeding in well-appearing infants can have benign causes like maternal blood or FPIAP.
  • FPIAP is a non-IgE-mediated food allergy manageable with dietary elimination.
  • The prognosis for FPIAP is excellent, with most children outgrowing the condition.

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