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J Pediatr. 2000 May;136(5):641-7.

Role of food protein intolerance in infants with persistent distress attributed to reflux esophagitis.

Author information

1
Departments of Allergy, Gastroenterology & Clinical Nutrition, and Anatomical Pathology, Royal Children's Hospital, Melbourne, Australia.

Abstract

BACKGROUND:

Distressed behavior is common in infants and is often attributed to gastroesophageal reflux (GER) or food protein intolerance.

OBJECTIVE:

To examine the effect of a hypoallergenic amino acid-based infant formula (AAF) on distressed behavior and GER symptoms in infants who failed to respond to extensively hydrolyzed formula and antireflux medications.

STUDY DESIGN:

Nineteen distressed infants (9 boys and 10 girls; median age, 5.0 months) with presumed GER underwent gastroscopy (n = 17) and esophageal 24-hour pH monitoring (n = 14). Double-blind placebo-controlled (DBPC) formula challenges of AAF versus previously besttolerated formula were conducted.

RESULTS:

Nine infants had histologic evidence of esophagitis, and 9 had inflammatory changes in the stomach and/or duodenum. Symptoms remitted in all infants within 2 weeks of the start of feeding with AAF. On DBPC challenge after a median period of 3 months of receiving AAF, 12 infants were intolerant to active formula (distress score, 287 vs 580 min/wk,P =. 01; symptom score, 23.1 vs 36.1, P =.03). Seven infants did not relapse and were considered tolerant (distress score, 470 vs 581, P =.77; symptom score, 29.5 vs 20.2; P =.89).

CONCLUSION:

Treatment with AAF may reduce distressed behavior and symptoms of GER in infants with food protein intolerance.

PMID:
10802497
DOI:
10.1067/mpd.2000.104774
[Indexed for MEDLINE]

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