Milk Protein Intolerance in Infancy

An estimated 7-15% of full term infants have an intolerance to milk proteins.  These infants often require formulas that contain hydrolyzed proteins or amino acids.  Infants are routinely re-evaluated for milk intolerance at 1 year of age since there is anecdotal evidence that most infants become tolerant by this age.  Researchers at the Winthrop University Hospital conducted a study to collect preliminary data for a timetable of when milk protein intolerance may resolve in infants.  The study, titled “Rapid Resolution of Milk Protein Intolerance in Infancy,” was published in the Journal of Pediatric Gastroenterology & Nutrition.  Twenty-five infants who were less than four months old and showed signs of milk protein intolerance were fed either casein hydrolysate or amino acid based formulas until symptoms of intolerance subsided for at least 2 months.  Infants were re-challenged with a formula they did not previously tolerate every 2-3 months to record when the infant became tolerant to milk proteins.  On average, infants were 6.7 months old when the milk intolerance was resolved.  Seventy-five percent of children did not show signs of milk intolerance by 7 months of age and the remaining infants appeared to be tolerant of milk protein by 10 months of age.  The authors concluded that it may be reasonable to treat infants with milk protein intolerance for 2 to 3 months with a hypoallergenic formula and then re-challenge them prior to 12 months age.  Additional studies are required to confirm these preliminary findings.  As there can be severe reactions when feeding an infant a food which they have shown intolerance, it may be best for infants to be referred to an allergist who can re-challenge the infant in a safe and proper setting.

Reference:  Lazare FB, Brand DA, Marciano TA, Daum F.  Rapid resolution of milk protein intolerance in infancy.  J Pediatr Gastroenterol Nutr. 2014 Aug;59(2):215-7. doi: 10.1097/MPG.0000000000000372.