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Food protein-induced allergic proctocolitis — RACP Paediatrics MCQ

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ModerateGastroenterologyFood protein-induced allergic proctocolitisRACP Paediatrics

A 3-month-old exclusively breastfed infant has intermittent blood and mucus in stools but is thriving and afebrile. Examination is normal and there is mild eczema; stool culture is negative. What would you advise the parents?

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Correct answer: A — Trial maternal cow's milk protein elimination with dietetic support

A thriving infant with blood and mucus in stool and eczema commonly has food protein-induced allergic proctocolitis; maternal dairy elimination while continuing breastfeeding is appropriate. Lactose intolerance does not usually cause blood in stools and stopping breastfeeding is not necessary. The pearl is that most infants remain well, but growth and symptom response should be monitored.

Reference: RCH Clinical Practice Guidelines; ASCIA food allergy resources