PDF(Pubmed)
Abstract：
A cellular proliferation to milk allergens has been found in the cord blood cells of neonates. While this reflects a sensitivity during the fetal life, its clinical significance and disease, particularly its unconventional presentations, have remained largely unrecognized by care providers. Here, we report three cases of infants whose mothers consumed dairy products during pregnancy, who developed a severely constipated pre- and postnatal bowel. The passage of meconium was significantly delayed with subsequent early-onset infant constipation that was intractable to conventional therapies but remitted when milk proteins were withheld, recurred when milk proteins were reintroduced, and resolved again when switched to an extensively hydrolyzed or amino acid-based infant formula. Based on this and other observations, it is believed that these infants must have initiated and/or developed cow\'s milk protein allergy prenatally during fetal life. We suggest that a 2-week trial of cow\'s milk protein avoidance be applied to these neonate infants with early-onset constipation before an unnecessary invasive work-up for Hirschsprung disease and others is initiated per the current guidelines.
摘要：
在新生儿的脐带血细胞中发现了对牛奶过敏原的细胞增殖。虽然这反映了胎儿生命中的敏感性，其临床意义和疾病，尤其是它的非常规演讲，基本上没有得到护理提供者的认可。这里,我们报告了三例母亲在怀孕期间食用乳制品的婴儿，患有严重便秘的产前和产后肠道。胎粪的通过显着延迟，随后的早发性婴儿便秘难以治疗，但当牛奶蛋白被抑制时，缓解，当重新引入牛奶蛋白质时复发，并在转换为广泛水解或基于氨基酸的婴儿配方食品时再次解决。基于这一点和其他观察，据认为，这些婴儿必须在出生前开始和/或发展牛乳蛋白过敏。我们建议对这些早发性便秘的新生儿进行为期2周的避免牛乳蛋白的试验，然后根据当前指南对先天性巨结肠和其他疾病进行不必要的侵入性检查。
