scholarly journals Allergic proctocolitis causing hematochezia in preterm twins

2020 ◽  
Vol 1 (1) ◽  
pp. 23-26
Author(s):  
Bipin Karki ◽  
Varsha Verma ◽  
Ritesh Shrestha ◽  
Suchita Shrestha Joshi

Allergic colitis due to cow’s milk or soy protein in commercially prepared infant formula or due to ingestion of breast-milk of mothers who are ingesting cow’s milk is a known cause of colitis occurring in infants. Allergic colitis can occur within days, weeks or months of birth and should be considered as a differential diagnosis in any infant presenting with hematochezia. Typically, there is a significant delay in the onset of milk allergy in premature infants compared to full term infants. We report a case of premature twin neonates who presented with profuse rectal bleeding during second week of life. The infants had been feeding expressed breast milk since birth and the nursing mother had been drinking cow’s milk. The infants had pneumatosis coli suggestive of inflammation of the colon while biochemical and hematological markers of inflammation were normal. Expressed breast milk was re-introduced after eliminating dairy from mother’s diet for 5 days. The infants were fed on mother’s milk and top up of hydrolyzed infant formula as required. Both the twins remained well.

PEDIATRICS ◽  
1992 ◽  
Vol 89 (6) ◽  
pp. 1105-1109 ◽  
Author(s):  

The pediatrician is faced with a difficult challenge in providing recommendations for optimal nutrition in older infants. Because the milk (or formula) portion of the diet represents 35% to 100% of total daily calories and because WCM and breast milk or infant formula differ markedly in composition, the selection of a milk or formula has a great impact on nutrient intake. Infants fed WCM have low intakes of iron, linoleic acid, and vitamin E, and excessive intakes of sodium, potassium, and protein, illustrating the poor nutritional compatibility of solid foods and WCM. These nutrient intakes are not optimal and may result in altered nutritional status, with the most dramatic effect on iron status. Infants fed iron-fortified formula or breast milk for the first 12 months of life generally maintain normal iron status. No studies have concluded that the introduction of WCM into the diet at 6 months of age produces adequate iron status in later infancy; however, recent studies have demonstrated that iron status is significantly impaired when WCM is introduced into the diet of 6-month-old infants. Data from studies abroad of highly iron-deficient infant populations suggest that infants fed partially modified milk formulas with supplemental iron in a highly bioavailable form (ferrous sulfate) may maintain adequate iron status. However, these studies do not address the overall nutritional adequacy of the infant's diet. Such formulas have not been studied in the United States. Optimal nutrition of the infant involves selecting the appropriate milk source and eventually introducing infant solid foods. To achieve this goal, the American Academy of Pediatrics recommends that infants be fed breast milk for the first 6 to 12 months. The only acceptable alternative to breast milk is iron-fortified infant formula. Appropriate solid foods should be added between the ages of 4 and 6 months. Consumption of breast milk or iron-fortified formula, along with age-appropriate solid foods and juices, during the first 12 months of life allows for more balanced nutrition. The American Academy of Pediatrics recommends that whole cow's milk and low-iron formulas not be used during the first year of life.


PEDIATRICS ◽  
1987 ◽  
Vol 80 (3) ◽  
pp. 434-438
Author(s):  
T. Tomomasa ◽  
P. E. Hyman ◽  
K. Itoh ◽  
J. Y. Hsu ◽  
T. Koizumi ◽  
...  

It is known that breast milk empties more quickly from the stomach than does infant formula. We studied the difference in gastroduodenal motility between neonates fed with human milk and those fed with infant formula. Twenty-four five-to 36-day-old neonates were fed with mother's breast milk or with a cow's milk-based formula. Postprandlial gastroduodenal contractions were recorded manometrically for three hours. Repetitive, high-amplitude nonmigrating contractions were the dominant wave form during the postprandial period. The number of episodes, duration, amplitude, and frequency of nonmigrating contractions were not different following the different feedings. The migrating myoelectric complex, which signals a return to the interdigestive (fasting) state, appeared in 75% of breast milk-fed infants but only 17% of formula-fed infants (P < .05) within the three-hour recording period. Because contractions were similar following the two meals, but a fasting state recurred more rapidly in breast-fed infants, we conclude that factors other than phasic, nonpropagated antroduodenal contractions were responsible for the differences in gastric emptying between breast milk and formula.


PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1067-1067
Author(s):  

A high level of success in infant nutrition has been achieved in the United States by breast-feeding as preferred, or by feeding with iron-fortified infant formulas. Minor controversies about feeding choices occur when infants are weaned from an all liquid diet to one containing a variety of solid foods. Weaning is not a single event but a process that takes place throughout a number of months, beginning optimally between 4 and 6 months of age. The nutritional objective is to achieve a varied diet with approximately 35% to 50% of energy coming from sources other than breast milk or infant formula. Variety remains the key to the diet, particularly for infants older than 6 months of age. Solid food must provide an adequate source of iron, trace minerals, and vitamins to replace and supplement those in that portion of breast milk or formula removed from the diet. Breast milk and fortified infant formula continue to be optimal for the milk segment of the diet during the second 6 months of life. The mother may choose to stop breast-feeding for a variety of reasons, however. The Committee on Nutrition has indicated that cow's milk could be substituted in the second 6 months of age provided that (1) the amount of milk calories consumed does not exceed 65% of total calories and (2) the solid food portion of the diet replace the iron and vitamins deficient in cow's milk. Recently "follow-up" feedings (formulas) have been marketed in the United States as they have been in Europe for many years.


PEDIATRICS ◽  
1991 ◽  
Vol 87 (4) ◽  
pp. 439-444
Author(s):  
Patrick S. Clyne ◽  
Anthony Kulczycki

Previous studies have suggested that an unidentified cow's milk protein, other than β-lactoglobulin and casein, might play a pathogenetic role in infant colic. Therefore, a radioimmunoassay was used to analyze human breast milk and infant formula samples for the presence of bovine IgG. Milk samples from 88 of the 97 mothers tested contained greater than 0.1 µg/mL of bovine IgG. In a study group of 59 mothers with infants in the colic-prone 2- to 17-week age group, the 29 mothers of colicky infants had higher levels of bovine IgG in their breast milk (median 0.42 µg/mL) than the 30 mothers of noncolicky infants (median 0.32 µg/mL) (P < .02). The highest concentrations of bovine IgG observed in human milk were 8.5 and 8.2 µg/mL. Most cow's milk-based infant formulas contained 0.6 to 6.4 µg/mL of bovine IgG, a concentration comparable with levels found in many human milk samples. The results suggest that appreciable quantities of bovine IgG are commonly present in human milk, that significantly higher levels are present in milk from mothers of colicky infants, and that bovine IgG may possibly be involved in the pathogenesis of infant colic.


PEDIATRICS ◽  
1963 ◽  
Vol 32 (6) ◽  
pp. 995-1001
Author(s):  
Arthur J. Newman ◽  
Samuel Gross

The case records of 11 infants with prolonged hyperbilirubinemia have been presented. The elevation of indirect reacting bilirubin in these infants may be due to interference with the normal conjugating mechanism by a substance present in breast milk. Introduction of cow's milk formulas should be carried out as part of any extensive investigation of prolonged hyperbilirubinemia of the indirect type in otherwise well infants who have been wholly breast fed from birth.


2011 ◽  
Vol 205 ◽  
pp. S269
Author(s):  
E.Y. Han ◽  
B.M. Lee ◽  
J.Y. Bae ◽  
I.Y. Ahn ◽  
S.K. Lim ◽  
...  

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