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Cow's milk protein allergy — DCH MCQ

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HardGrowth and nutritionCow's milk protein allergyDCH

A 4-month-old formula-fed infant has blood-streaked stools, eczema and vomiting after feeds. Growth has slowed but he is hydrated and afebrile. What is the most likely diagnosis?

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Correct answer: C — Cow's milk protein allergy

Blood-streaked stools, eczema, vomiting and faltering growth in early infancy suggest cow's milk protein allergy. Pyloric stenosis causes projectile vomiting and dehydration rather than eczema and bloody stools. The pearl is to assess growth and consider a supervised elimination trial using appropriate formula advice.

Reference: NICE CKS Cow's milk allergy