Food Intolerance

Question 0

Incomplete Starch Digestion

Answer 0

Pancreatic maturity not until 4mos

Adding rice cereal/increased starch > undigested starch in colon&raquo_space; bacterial fermentation&raquo_space; bloating, gassiness

Question 1

Cow’s Milk Protein Allergy Sx

Answer 1

Diarrhea, FTT, hematochezia, anemia, emesis

IgE-mediated: true allergy (also avoid soy)
non IgE-mediated: intolerance

Question 2

Lactose Intolerance

Answer 2

Lactose concentrations “mature” by 36wks CGA
Congenital/early-onset rare: voluminous diarrhea
Secondary: s/t after diarrheal illness, d/t Celiac

Question 3

Cow’s Milk Protein Allergy IgE-Mediated

Answer 3

Urticaria, angioedema, rhinoconjunctivitis, acute bronchospasm, oral allergy syndrome, GI anaphylaxis

*avoid cow’s milk until >1yo (soy ok)

Question 4

Cow’s Milk Protein Allergy IgE OR NOT

Answer 4

Atopic dermatitis, asthma, eosinophilic esophagitis/gastritis/gastroenteritis

Question 5

Cow’s Milk Protein Allergy NOT IgE Mediated

Answer 5

Contact dermatitis, food-induced pulmonary hemosiderosis/enterocolitis/proctocolitis/enteropathy, GERD

• avoid cow’s milk AND SOY until >1yo
• hydrolyzed (or amino acid but more expensive) formula

Question 6

Cow’s Milk Protein Allergy/Intolerance (CMPA) vs Lactose Intolerance (LI)

Answer 6

CMPA- diarrhea, irritability, rash, vomiting

LI- diarrhea, irritability, bloating, flatulence

Question 7

FPIES (food protein-induced enterocolitis syndrome)

Answer 7

• non-IgE-mediated severe cow milk protein intolerance
• can occur in BF
• p/w FOBT +, hematochezia, nl abd exam
• soy formula won’t help even though NOT IgE-mediated
• mom can avoid all cow’s milk or protein hydrolysate formula