INTOLERANCE TO PROTEIN HYDROLYSATE INFANT FORMULAS - AN UNDERRECOGNIZED CAUSE OF GASTROINTESTINAL SYMPTOMS IN INFANTS

The purpose of this study was to determine the effectiveness of an ami no acid-based infant formula in infants with continued symptoms sugges tive of formula protein intolerance while they were receiving casein h ydrolysate formula (CHF). Twenty-eight infants, 22 to 173 days of age, were enrolled; each had received CHF for an average of 40 days (10 to 173 days) and continued to have bloody stools, vomiting, diarrhea, ir ritability, or failure to gain weight, or a combination of these sympt oms. Sigmoidoscopy with rectal biopsy was performed in all infants. Th e infants then received an amino acid-based infant formula, Neocate, f or 2 weeks. After. 2 weeks of treatment, 25 of the infants demonstrate d resolution of their symptoms and underwent challenge with CHE Of the 25 who were challenged, eight tolerated the CHF and the remainder had recurrence of their symptoms. The histologic features in these infant s varied from eosinophilic infiltration to normal. We conclude that no t all infants with apparent formula protein-induced colitis respond to CHF and that these infants may have resolution of their symptoms when fed an amino acid-based infant formula.