حساسيت به شيرگاو در شيرخواران مبتلا به كوليك

Cowʹs Milk Allergy in Infantile Colic

Introduction & Objective: Cowʹs milk allergy has been considered as a cause of infantile colic. Many physicians change the diet of these infants to a cowʹs milk free diet. In this study, we evaluated the role of cowʹs milk allergy in infantile colic in breast fed infants Materials & Methods: This single blind clinical trial was done in infants between three weeks and three months old with infantile colic who were referred to a subspecialty clinic in Shiraz-Iran from September 2003 to February 2004. Only exclusively breast fed infants were selected. For other infants who were formula fed, only a questionnaire was filled out, stool exam was performed and they were then excluded from the study. Skin prick tests with cowʹs milk and stool exams (for occult blood) were performed for these infants, and the correct technique of breast feeding was taught to their mothers. Then, the infants were divided to case and control groups randomly. in the case group, the mothers were advised not to consume cowʹs milk and other dairy products for two weeks. But in the control group, no change in the diet of the mothers was recommended. Furthermore, 50 healthy infants without symptoms of colic were included in the study as the second control group. Their mothers were asked about the type of feeding and stool exams were done for them. Finally, the data were analyzed using chi-square test. Results: From all 270 examined infants, colic was confirmed in 169 cases. Among them, 153 infants were breast fed exclusively. 114 cases in this group allowed the skin prick test to be done. The test was positive in only 3 infants (2.6%). From these 114 infants, only 77 infants completed the study. 35 infants were in the case group and 42 infants were in the control group. Infants with colic whose mothers did not take dairy products, did not improve significantly in comparison with the control group. Prevalence of formula feeding was significantly higher in colicky infants in comparison with non-colicky infants (24% and 2% respectively). Prevalence of occult blood in the stools of colicky infants was significantly higher in colicky infants than non-colicky infants (24% and zero respectively). Conclusion: Due to the unresponsiveness of infants to the elimination of cowʹs milk, it can be concluded that cowʹs milk allergy is not a common cause of infantile colic. Therefore, it is not advised to eliminate the dairy products from the diet of nursing mothers. Also, it is not necessary to perform skin prick tests as a routine test in these infants. The high prevalence of occult blood in the stools of infants suffering from colic is a new finding. Evaluation of its cause will be helpful in determining the etiology of infantile colic..