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Cow's milk protein sensitive enteropathy (CMPSE) in infants is often linked to early formula feeding. Exclusive breastfeeding is the best prevention for this condition, which typically resolves within a year.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Nutrition
Context:
- Cow's milk protein sensitive enteropathy (CMPSE) affects infants, often those not exclusively breastfed.
- Risk factors include prematurity, prior enteritis, trisomy 21, and neonatal abdominal surgery.
- Infants typically present within two weeks of cow's milk formula introduction.
Purpose:
- To describe the characteristics, diagnosis, and management of CMPSE.
- To highlight the link between feeding practices and CMPSE development.
- To emphasize the importance of exclusive breastfeeding for prevention.
Summary:
- CMPSE presents with gastrointestinal symptoms like diarrhea, vomiting, and abdominal distension, with potential for villous atrophy in the small intestine.
- Bloody stools indicate large bowel involvement.
- The condition is usually transient, resolving within a year, but inadequate management can lead to intractable diarrhea syndromes.
Impact:
- Highlights the critical role of exclusive breastfeeding in preventing CMPSE.
- Warns against soy-based formulas as a first-choice alternative due to secondary intolerance.
- Informs clinical practice regarding infant feeding recommendations and CMPSE management.
Abstract:
Cow's milk protein sensitive enteropathy (CMPSE) is characterized by the following items: 1. The great majority of affected infants have not been breast fed or only for a few days. Additional risks are immaturity, preceding enteritis, trisomy 21, and abdominal operation in the newborn. 2. Half of the patients become ill during the first two weeks after starting cow's milk formula. The main symptoms are watery, mucus containing diarrhea, vomiting, abdominal distension, pallor and rapid weight loss. 3. In CMPSE the small intestinal mucosa shows varying degrees of inflammation and villous atrophy. Bloody stools refer to large bowel affection. 4. CMPSE is always transitory and usually persists for less than one year. Inadequate treatment leads to "severe protracted diarrhea" or "intractable diarrhea" syndrome. Soya-based formula should not be the diet of first choice, since secondary intolerance to soya proteins will frequently develop. Exclusive breast feeding during the first months of life is the best prophylaxis of CMPSE.