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Solid-food Introduction in Infants Diagnosed As Having a Cow's-milk Protein–induced Enterocolitis

Beauchamp, Josée N*; Gaboury, Isabelle; Ni, Andy; Boland, Margaret P*; Mack, David R*

Journal of Pediatric Gastroenterology & Nutrition: May 2011 - Volume 52 - Issue 5 - p 639–643
doi: 10.1097/MPG.0b013e318207ef1a
Clinical Trials

Objectives: In a prior retrospective analysis of 32 infants diagnosed with cow's-milk protein–induced enterocolitis (CMPIE), gastrointestinal (GI) symptoms were observed with the introduction of milk-free infant cereal. The aim of this randomized controlled trial was to compare the incidence of new GI symptoms with the introduction of either milk-free infant rice cereal or carrots as the first complementary food at 6 months of age in infants previously diagnosed as having CMPIE.

Patients and Methods: Thirty-nine infants were enrolled in the study. Twenty were randomized to start with pureed carrots and 19 were randomized to start with milk-free infant rice cereal. GI signs and symptoms developing within 2 weeks were recorded.

Results: No significant differences were noticed in the incidence of new GI symptoms and the change in the frequency of GI symptoms upon solid-food introduction, whether it was carrots or milk-free infant rice cereal. A high overall incidence rate (47%) of new GI symptoms was observed in the whole cohort. The mean number of days for onset of new symptoms was 6. The most common GI signs and symptoms observed were related to alteration of stool characteristics. Breast-feeding was not shown to have a protective effect on the development of new GI symptoms during solid-food introduction.

Conclusions: Many infants with CMPIE will develop GI signs and symptoms following the introduction of solid food, whether milk-free infant rice cereal or carrots are introduced, and their onset may be delayed.

*Division of Gastroenterology, Hepatology and Nutrition, Canada

Research Institute of the Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Received 4 June, 2010

Accepted 21 November, 2010

Address correspondence and reprint requests to Josée Beauchamp, RD, MSc, CNSC, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1 Canada (e-mail: beauchamp@cheo.on.ca).

The Canadian Foundation for Dietetic Research funded this study.

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN