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Non-IgE cow's milk protein allergy — RACP Paediatrics MCQ

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ModerateGastroenterologyNon-IgE cow's milk protein allergyRACP Paediatrics

A 3-month-old has streaks of blood and mucus in stools but is otherwise thriving. He is breastfed, afebrile and examination is normal. Stool culture is negative. The mother asks whether breastfeeding should stop. What would you advise the parents?

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Correct answer: C — Continue breastfeeding while trialling maternal cow's milk elimination with review

Food protein-induced allergic proctocolitis can cause blood-streaked stools in a thriving breastfed infant. Breastfeeding can continue while maternal cow's milk elimination is trialled with planned review and reintroduction strategy. Lactose intolerance is not the usual mechanism and lactose-free formula is not the first step.

Reference: RCH Cow's milk allergy guideline; RACP Knowledge Guides