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Cow's milk associated rectal bleeding: a population based prospective study.
MedLine Citation:
PMID:  23050491     Owner:  NLM     Status:  Publisher    
BACKGROUND: Isolated rectal bleeding in infants is often attributed to the consumption of cow's milk. However, the prevalence of this condition has not been described, and its preferred diagnostic methods and management are controversial. METHODS: In a prospective population-based study following 13,019 children from birth, 21 infants with isolated rectal bleeding attributed to cow's milk protein consumption were identified. Following evaluation, parents were encouraged to resume cow's milk protein and infants were followed for reappearance of symptoms and thereafter for 6 yr. In addition, infants with rectal bleeding were compared to a control group of healthy infants. RESULTS: The prevalence of isolated rectal bleeding attributed to cow's milk consumption was 0.16%. All infants were asymptomatic within days of dietary modifications. Eleven of the 14 infants (78.5%) whose parents reintroduced cow's milk protein to their diet following our evaluation tolerated it with no adverse effects. Those 11 infants were significantly younger at initial consumption of cow's milk protein (6.7 ± 1.6 months) compared to those who continued elimination diet (17.7 ± 9.2 months), (p = 0.002) while their 1-yr hemoglobin levels were comparable (p = 0.98). No risk factors for rectal bleeding were identified. CONCLUSIONS: The prevalence of isolated rectal bleeding attributed to cow' milk is low. The condition is generally benign and resolves quickly with elimination diet. Reintroduction of cow's milk following resolution of symptoms is often well tolerated and is recommended for confirming the diagnosis and avoiding prolonged unnecessary elimination diets.
Arnon Elizur; Michal Cohen; Michael R Goldberg; Nelly Rajuan; Adi Cohen; Moshe Leshno; Yitzhak Katz
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-11
Journal Detail:
Title:  Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology     Volume:  -     ISSN:  1399-3038     ISO Abbreviation:  Pediatr Allergy Immunol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9106718     Medline TA:  Pediatr Allergy Immunol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Department of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel; Allergy and Immunology Institute, Assaf Harofeh Medical Center, Zerifin, Israel.
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