MILK FEEDING AND COWS MILK PROTEIN INTOLE RANCE IN INFANTS

Background. - Cow milk protein intolerance (CMPI) is characterized by a wide range of symptoms and signs affecting the gastro-intestinal tra ct, the respiratory system and the skin. A better definition, a strict er application of diagnostic criteria and critical evaluation of certa in immunologic correlates can contribute to a better understanding and preventive treatment of this entity. Population and methods. - Two hu ndred-seventeen infants with CMPI seen between January 1980 and Decemb er 1993 were included in the study. They were classified into two grou ps: 1) acute reaginic CMPI (type I): 125 infants and 2) CMP enteropath y or colitis (type III or IV): 92 infants, according to classical diag nostic criteria. Careful investigation concerning the type of milk fee ding (breast or artificial) proposed prior to clinical manifestations was performed. Results. - Among the 125 infants (aged 3 to 20 weeks) w ith acute reaginic CMPI, 121 (97%) had been breast-fed with a sudden w eaning; 30 of these infants had also received one to three formula bot tles during the first 3 days of life and 14 certainly had not received such formula bottles. Among the 92 infants,vith CMPI, type III or IV, 33 (38%) had been exclusively breast-fed a figure quite similar to th e breastfeeding incidence in our region. Conclusions. - These results clearly show the importance of breast-feeding in the personal history of CMPI. Acute reaginic type of CMPI is favored by early ingestion of formula bottles in breast-fed infants and by early sudden weaning. Hyp oallergenic formula in five cases was unable to protect infants agains t further allergic manifestation.