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Proctocolitis in exclusively breast-fed infants

L Anveden-Hertzberg¹, Y Finkel, B Sandstedt

¹Department of Paediatric Surgery, St. Göran's Hospital, Stockholm, Sweden.

European Journal of Pediatrics

|June 1, 1996

Summary

Mild rectal bleeding in exclusively breast-fed infants may be caused by cow's milk protein allergy. Dietary changes in mothers breastfeeding their infants can resolve proctocolitis symptoms.

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Area of Science:

Pediatrics
Gastroenterology
Allergy & Immunology

Background:

Proctocolitis, characterized by rectal bleeding, can occur in exclusively breast-fed infants.
The etiology of proctocolitis in this population is not fully understood.

Purpose of the Study:

To investigate the potential role of cow's milk protein allergy in exclusively breast-fed infants presenting with proctocolitis.
To evaluate the efficacy of maternal dietary restriction of cow's milk protein.

Main Methods:

Rectosigmoidoscopy and rectal mucosal biopsy were performed in nine exclusively breast-fed infants with rectal bleeding.
Histological examination revealed eosinophilic infiltration in rectal biopsies.
Maternal intake of cow's milk protein was restricted in seven mothers.

Main Results:

Rectosigmoidoscopy showed inflammatory changes, including oedematous mucosa and petechial haemorrhages.
Rectal biopsies revealed intra-epithelial eosinophilic granulocytes and lamina propria eosinophilia.
Six out of seven infants whose mothers restricted cow's milk protein intake showed symptom resolution within 4 weeks.

Conclusions:

Cow's milk protein allergy transferred via breast milk is a potential cause of proctocolitis in exclusively breast-fed infants.
Maternal dietary restriction of cow's milk protein appears to be an effective treatment for this condition.

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