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conferenceseries
.com
Volume 04
Journal of Neonatal & Pediatric Medicine
Neonatal Nursing Congress 2018
May 14-15, 2018
May 14-15, 2018 Singapore
30
th
Global Experts Meeting on
Neonatal Nursing &
Maternal Healthcare
Case report of exclusively breast-fed neonate with Cow Milk Protein Allergy (CMPA)
Sandhya Ghai, Praveen Kumar and Geetanjli Kalyan
Postgraduate Institute of Medical Education & Research, India
The occurrence of Cow Milk Protein Allergy (CMPA) has been recognized in India. Overall the incidence of CMPA in the
infants fed with formula milk is 5-7% and in breastfed infants it is 0.5-1%. Though the incidence is less in breastfed infants and
early presentation is rare here in this case report we present a case of CMPA associated with exclusive breastfeeding. A three
months old female baby presented with complaints of streaks of blood in stool. The infant had one episode of blood streak in
stool at two months of age. At three months of age baby was brought for neonatal consultation when episode of blood streak in
stool increased to 4 times in a week. The baby was otherwise well. Stool examination revealed reddish yellow ill formed alkaline
reaction with traces of mucus and blood, pus cells 12-15, RBC 10-12/HPF, no cyst/ova and eosinophil count was 3 cells/cmm
and occult blood positive. Colonoscopy revealed loss of vascular pattern and nodularity + throughout. Biopsy finding revealed
intact colonic lining epithelium. Lamina propria shows focal congestion, moderate lymphoplasmacytic cells infiltrate with
occasional eosinophils, bits of colonic mucosa with surface inflammatory cell exudate. No significant increase in eosinophils
was noted. The mother reported an increased intake of milk and almonds in the days prior to the episode. As the episodes of
blood streaks in stool increased, she was initially advised to stop almonds and eggs. But the symptoms did not subside and she
was then advised total exclusion of CMP in her diet. The symptoms however, still persisted. Dietary evaluation revealed intake
of CMP from sources having hidden content of milk e.g. bread. Mother was again counseled for CMP free diet and breast feed
was continued. The episodes of blood streaks in baby’s stools settled. Gradually complementary feed was started at five months
of age with semolina (suji) halva and mashed banana. In conclusion, we share our experience of managing a case of allergic
proctocolitis due to CMPA in an exclusively breast fed neonate. It is important to remember hidden sources of CMP intake
while modifying maternal diet.
Biography
Sandhya Ghai is working as a Principal at National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
She has received Doctorate degree from Panjab University, Chandigarh. She published more than 100 papers in national and international journals. She was
awarded with Best Educationist Award and is life member of many organizations.
sandhya.ghai@yahoo.comSandhya Ghai
et.al, Neonat Pediatr Med 2018, Volume 4
DOI: 10.4172/2572-4983-C1-002