Allergic Proctocolitis in Breastfed Infants
Mother's Milk Baby Develops Cows' Milk Induced Allergic Colitis
Oct 14, 2009
In May of 2000 the medical journal Pediatric Radiology reported a previously unheard of occurrence when an exclusively breastfed baby boy was diagnosed with a cows' milk-induced allergy.
Upon examination, the eight week old male infant demonstrated irritability and non-bilious projectile vomiting. Non-bilious and projectile vomiting means that the breast milk came out undigested, unclabbered, and with great force; possibly shooting out several feet. In an infant, this usually indicates a medical emergency.
Pyloric Stenosis
One of the first things doctors like to rule out in a case like this is a condition known as pyloric stenosis, in which the pyloric valve opening to the small intestine has become so thickened that food cannot empty from the stomach. This is a not-so-rare emergency, especially in young male babies of this age.
But pyloric stenosis in infants is usually caused by an allergic reaction to oral erythromycin or is linked to proteins found in soy and cows’ milk based formulas. In the end an ultrasound examination showed that the baby was more likely to have colitis, an inflammation of the large intestine.
Allergic Colitis or Infectious Colitis?
Upon further exploring the tiny patient’s history, it was discovered that he had also been having episodes of painful colic and that some blood had been seen in his stools. With this information and a rectal biopsy, infectious colitis was ruled out, which supported the diagnosis of allergic proctocolitis.
Infants' Allergies are Common
Many parents have been told that babies of this age do not develop allergies or that they are very rare. Yet, food allergies are quite common in infants. This is why in cases of families with broad histories of allergies doctors will often counsel mothers to breastfeed exclusively for at least six months; and thereafter avoid all dairy, soy and other potential allergens throughout the baby’s first year.
If gastrointestinal symptoms develop despite doctors’ feeding recommendations, these are some of the easiest allergic reactions to recognize. A food allergy in an infant may cause any combination of the following:
- Excessive gas
- Vomiting
- Constipation
- Loose bowels
- Colic and cramping
- Blood in stools
Streaks of blood in the stool, in particular, are a very strong indication of the possibility of a cows’ milk allergy. Yet, parents should be aware that even when there is no visible blood in the stool enough bleeding can still exist to cause anemia in a baby. In any such case, it is important for parents to seek medical advice as soon as possible.
How Can a Breastfed Infant Develop a Cows’ Milk Allergy?
A 2001 Postgraduate Medical Journal (PMJ) article stated, “dietary protein induced proctocolitis in exclusively breast fed infants is rarely taken into consideration,” yet, if the infant’s mother consumes dairy products, cows’ milk proteins can be transferred to her infant via the mother’s breast milk.
Allergic Colitis or Proctocolitis Treatment
The treatment for this allergy with terrifying symptoms is incredibly simple, and the baby’s recovery is swift.
The PMJ article explains that the standard treatment for allergic proctocolitis in breastfed infants is as simple as removing the allergen from the mother’s diet. The journal reported that infants’ rectal bleeding had resolved in each of the study’s five diagnosed cases 72 to 96 hours after the mothers had discontinued consuming the offending proteins.
Reference
- Y. Patenaude, et al. Cow's-milk-induced Allergic Colitis in an Exclusively Breast-fed Infant: Diagnosed with Ultrasound. (Pediatr Radiol 2000 30: 379-382)
- W. Pumberger, et al. Proctocolitis in Breast Fed Infants: A Contribution to Differential Diagnosis of Haematochezia in Early Childhood. (Postgrad Med J 2001 77: 252-254)
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Disclaimer
The information in this article is presented for educational purposes only. No diagnosis should be made nor treatment undertaken without first consulting a Physician or other qualified health professional, as neither Suite101 nor the author will be responsible for readers' actions. Images are provided for illustrative purposes only.
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