Cow's Milk Protein Allergy — RACP Paediatrics MCQ

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ModerateGastroenterologyCow's Milk Protein AllergyRACP Paediatrics

A 5-month-old formula-fed infant presents with bloody stools, vomiting, and eczema. He has no fever and is thriving. Stools contain mucus and fresh blood. What is the most likely diagnosis?

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Correct answer: E — Cow's milk protein allergy (non-IgE mediated)

Bloody mucoid stools in a young infant with eczema and no systemic illness is most consistent with non-IgE mediated cow's milk protein allergy (food protein-induced allergic proctocolitis/enterocolitis). Management involves elimination of cow's milk protein from the diet (extensively hydrolysed formula or amino acid-based formula). Most children outgrow this by 12–18 months.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Non-IgE Mediated Food Allergy