scholarly journals The Consequence of Excessive Consumption of Cow’s Milk: Protein-Losing Enteropathy with Anasarca in the Course of Iron Deficiency Anemia—Case Reports and a Literature Review

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 828
Author(s):  
Karolina Graczykowska ◽  
Joanna Kaczmarek ◽  
Dominika Wilczyńska ◽  
Ewa Łoś-Rycharska ◽  
Aneta Krogulska
Keyword(s):  
Iron Deficiency ◽  
Literature Review ◽  
Iron Deficiency Anemia ◽  
Case Reports ◽  
Deficiency Anemia ◽  
Cow’S Milk ◽  
Milk Consumption ◽  
Protein Losing Enteropathy ◽  
Cow's Milk ◽  
Excessive Consumption

Cow’s milk is a key component of a child’s diet. While the consumption of even trace amounts can result in allergy to its proteins and/or hypolactasia, excessive cow’s milk consumption can result in numerous health complications, including iron deficiency, due to the diet being improperly balanced. Although the incidence of iron deficiency has declined, it remains the most widespread nutritional deficiency globally and the most common cause of anemia. One rare consequence of anemia caused by iron deficiency is protein-losing enteropathy; however, the mechanisms of its development are unclear. The following manuscript, based on a literature review, presents two rare cases of children, a 16-month-old boy and a 2.5-year-old girl, who developed severe microcytic anemia, enteropathy with hypoalbuminemia, and anasarca as a result of excessive cow’s milk consumption. It highlights the possible relationship between excessive consumption of cow’s milk in children and severe iron deficiency anemia with accompanying hypoalbuminemia; it may also result in serious clinical conditions, even in children that do not demonstrate food hypersensitivity.

Severe Iron-Deficiency Anemia Still an Issue in Toddlers

2014 ◽  
Vol 53 (14) ◽  
pp. 1352-1358 ◽  
Author(s):  
Gabrielle Paoletti ◽  
Debra L. Bogen ◽  
A. Kim Ritchey
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Motor Development ◽  
Retrospective Chart Review ◽  
Microcytic Anemia ◽  
Deficiency Anemia ◽  
Cow’S Milk ◽  
Milk Consumption ◽  
Cow's Milk ◽  
The Mean

Background and Objectives. Chronic, severe iron-deficiency anemia (IDA) in the first years of life increases the risk of irreversibly compromised cognitive, affective, and motor development. While IDA in infants has decreased because of dietary changes (iron-fortified formula and delaying cow’s milk), toddlers (13-36 months) are equally vulnerable to the adverse effects of IDA. We aimed to show that despite public health efforts, severe IDA remains a problem in toddlers and is associated with excess milk consumption. Methods. Retrospective chart review of children 6 to 36 months admitted to or evaluated by hematology at a children’s hospital from January 1, 2005 to December 31, 2010 with a severe microcytic anemia (hemoglobin [Hb] <9 g/dL and mean corpuscular volume (MCV) <75 fL). Results. We identified 68 infants and toddlers with severe IDA; most (84%) were 13 to 36 months old. The mean Hb and MCV were 6.0 g/dL (range = 2.2-8.9 g/dL) and 54.0 fL (range = 45.5-69.8 fL), respectively. Fatigue, poor appetite, and pica were the most common symptoms, found in 43%, 29%, and 22% of patients, respectively. Only 41% of parents reported pale skin while 77% of physicians recorded it on physical exam. Daily cow’s milk consumption surpassed 24 ounces for 47 of 48 children with reported intake; 11 consumed more than 64 ounces per day. Conclusions. Despite current screening recommendations, severe IDA continues to be a problem in toddlers and strongly correlates with excess cow’s milk consumption. This reiterates the importance of screening for IDA into routine toddler care.

Cow's milk consumption and iron deficiency anemia in children

2005 ◽  
Vol 81 (5) ◽  
pp. 361-367 ◽  
Author(s):  
Maria A. A. Oliveira ◽  
Mônica M. Osório
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Cow’S Milk ◽  
Milk Consumption ◽  
Cow's Milk

Too Much of a Good Thing? Cerebral Sinovenous Thrombosis Due to Excessive Milk Intake Associated Anemia

2020 ◽  
Vol 35 (9) ◽  
pp. 585-590
Author(s):  
Raquel Farias-Moeller ◽  
Sara Siddiqui ◽  
Megan Orr ◽  
Lileth Mondok
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Mean Corpuscular Volume ◽  
Milk Intake ◽  
Deficiency Anemia ◽  
Cow’S Milk ◽  
Corpuscular Volume ◽  
Cow's Milk ◽  
Cerebral Sinovenous Thrombosis ◽  
Sinovenous Thrombosis

Introduction: In young children, excessive cow’s milk intake causes iron-deficiency anemia, which is associated with hypercoagulable states. We present a case series of 4 toddlers with excessive milk intake iron-deficiency anemia and cerebral sinovenous thrombosis. Methods: Retrospective chart review of 4 patients was performed for patients with cerebral sinovenous thrombosis and iron-deficiency anemia secondary to excessive milk intake. Iron-deficiency anemia was defined as hemoglobin <11 mg/dL, mean corpuscular volume <70 fL, and serum ferritin <12 μg/L. Excessive milk intake was defined as consumption of >24 oz daily. Clinical, laboratory, and radiographic features were reviewed. Results: Age ranged from 12 to 24 months. Average hemoglobin, hematocrit, mean corpuscular volume, and ferritin levels were 6.1 g/dL, 22.7 g/dL, 52.7 fL, and 3.2 ng/mL, respectively. Daily milk consumption ranged from 40 to 60 oz. All patients presented with focal neurologic deficits, including seizures in 3. The location of cerebral sinovenous thrombosis varied, and 3 patients had venous infarcts, one of them hemorrhagic. All patients had a limited diet and were described as “picky eaters” by their parents, and only 1 had transitioned of a bottle. All patients were treated with anticoagulation, iron supplementation, and extensive dietary counseling to reduce cow’s milk intake. Conclusion: Iron-deficiency anemia due to excessive milk intake is an important and preventable etiology of pediatric cerebral sinovenous thrombosis. Focused anticipatory guidance is necessary for at-risk groups to prevent this neurologic emergency.

scholarly journals Cow's milk, infant formula and iron-deficiency anemia

2006 ◽  
Vol 82 (2) ◽  
pp. 161-164
Author(s):  
Mauro Batista de Morais ◽  
Dirce Maria Sigulem
Keyword(s):  
Iron Deficiency ◽  
Infant Formula ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Cow’S Milk ◽  
Cow's Milk

Breast-Feeding or Infant Formula Should Be Continued for 12 Months

PEDIATRICS ◽  
1983 ◽  
Vol 71 (6) ◽  
pp. 984-985
Author(s):  
CALVIN WOODRUFF
Keyword(s):  
Iron Deficiency ◽  
Blood Loss ◽  
Infant Formula ◽  
Iron Deficiency Anemia ◽  
Breast Feeding ◽  
Occult Blood ◽  
Deficiency Anemia ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Hemoccult Test

To the Editor.— The age at which the feeding of fresh homogenized cow's milk can produce occult blood loss has not been determined. The most recent study1 suggests that iron-replete infants fed less than 1 L/day are susceptible when less than age 140 days but not between 140 and 196 days (4.7 to 6.5 months). This study used the Hemoccult test, a relatively insensitive test for blood in the stool. A review of the feeding histories of 12 infants previously reported22 and four studied subsequently who had evidence of iron deficiency anemia associated with the ingestion of large amounts of fresh homogenized cow's milk (1 to 2 L daily) showed that eight of the 16 infants hed received infant formula with or without iron for at least 6 months, and four others for at least 3 months.

Iron Status and Infant Feeding Practices in an Urban Ambulatory Center

PEDIATRICS ◽  
1983 ◽  
Vol 72 (1) ◽  
pp. 33-36
Author(s):  
P. David Sadowitz ◽  
Frank A. Oski
Keyword(s):  
Iron Deficiency ◽  
Infant Feeding ◽  
Iron Deficiency Anemia ◽  
Iron Status ◽  
Feeding Practices ◽  
Deficiency Anemia ◽  
Cow’S Milk ◽  
Infant Feeding Practices ◽  
Cow's Milk ◽  
Iron Deficient

The relationship of infant feeding practices to iron status was examined in a group of 280 infants, 9 to 12 months of age, attending a "well-baby" clinic. Of this group, 7.6% were found to be iron depleted, 19.7% were iron deficient without anemia, and 8.2% were iron deficient with anemia. The incidence of iron-deficiency anemia was significantly greater in the black infants than the white infants (14.3% v 2.7%). The introduction of whole cow's milk into the diet had occurred prior to 6 months of age in 29.2% of the infants, and 62.1% of these infants had laboratory evidence of nutritional iron inadequacy, as contrasted with only 21.8% of those with iron deficiencies fed cow's milk after 6 months of age. Of the 21 infants with iron-deficiency anemia, 19 (90.5%) had been fed whole cow's milk prior to 6 months of age. Iron deficiency remains a nutritional problem for infants in an urban setting and is largely a result of the early introduction of whole cow's milk into the diet.

scholarly journals Dietary deficiencies among families of air warriors: Use of iron deficiency anemia as an index

2020 ◽  
Vol 64 ◽  
pp. 27-31
Author(s):  
N Gupta ◽  
V Vempati ◽  
A Agarwal
Keyword(s):  
Regression Analysis ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Dietary Habits ◽  
Dietary Diversity ◽  
Linear Regression Analysis ◽  
Deficiency Anemia ◽  
Cow’S Milk ◽  
Age Group ◽  
Cow's Milk

Introduction: Anemia is a prevalent health problem in India affecting all age groups. It has shown the highest prevalence among preschool children and occurs more commonly in the lower socioeconomic group. Observationally, it was noticed at an Air Force station that preschool children of air warriors had iron deficiency anemia at levels similar to those seen in lower socioeconomic groups. This prompted us to evaluate dietary practices among families of air warriors as a contributory factor to iron deficiency in these children. Material and Methods: All anemic children diagnosed of iron deficiency in the age group of 6–59 months were included in the study. Data were compiled from the clinical history, dietary habits and laboratory parameters obtained. The dietary habits were analyzed based on parameters defined in the current infant and young child feeding guidelines such as exclusive breastfeeding, minimum meal frequency, minimum dietary diversity, and minimum acceptable diet. Mann–Whitney U-test was used to determine statistical significance of difference between means of two independent groups. Spearman correlation analysis between two independent variables was done and multiple linear regression analysis was performed to identify predictor variables for iron deficiency anemia. Results: About 74.1% of the anemic children fell into age group of 6–23 months (infants and young children). 75% of children of the age group of 6–23 months were started on cow’s milk at the time of weaning. The average amount of cow’s milk consumed in a day was 0.7 L. In this age group, the minimum dietary diversity was observed in 11.1%, minimum acceptable diet in 5.5% and minimum meal frequency in 22.2% of the children. In the same age group, a statistically significant negative correlation was observed between cow’s milk quantity given per day and hemoglobin (ρ = ‒0.77). A significant negative correlation was found between cow’s milk quantity and variables such as age and number of solid meals received in a day (ρ = ‒0.553 and –0.526, respectively). In multiple regression analysis with hemoglobin as the dependent variable, a significant negative association was observed with cow’s milk quantity. Age showed statistically significant positive correlation with hemoglobin (ρ = 0.762) which was also seen on linear regression analysis. Serum ferritin was low in 44.5% while total iron-binding capacity was raised in 100% of the cases. Conclusion: Iron deficiency anemia was disproportionately distributed among infants and young children (age group 6–23 months). Copious consumption of cow’s milk in this age group led to fewer solid feeds per day and lack of dietary diversity which led to an iron deficient state in these children. This probably resulted in manifestation of anemia in this population. The study brings out the need for dietary counseling for air warriors and their families to ensure better health and lower disease burden.

Cow's milk, infant formula and iron-deficiency anemia - Authors' reply

2006 ◽  
Vol 82 (2) ◽  
pp. 161-164
Author(s):  
Maria A. A. Oliveira ◽  
Mônica M. Osório
Keyword(s):  
Iron Deficiency ◽  
Infant Formula ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Cow’S Milk ◽  
Cow's Milk

Iron-Deficiency Anemia Associated With Hiatal Hernia: Case Reports and Literature Review

2010 ◽  
Vol 49 (10) ◽  
pp. 984-985 ◽  
Author(s):  
Banafsheh Sinaki ◽  
Somasundaram Jayabose ◽  
Claudio Sandoval
Keyword(s):  
Iron Deficiency ◽  
Literature Review ◽  
Hiatal Hernia ◽  
Iron Deficiency Anemia ◽  
Case Reports ◽  
Deficiency Anemia
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