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Cow milk feeding in infancy: further observations on blood loss from the gastrointestinal tract.
J Pediatr. 1990 Jan; 116(1):11-8.JPed

Abstract

Because feeding of cow milk causes normal infants to lose increased amounts of occult blood from the gastrointestinal tract, we conducted a prospective trial to measure intestinal blood loss quantitatively and to monitor iron nutritional status. Fifty-two infants entered the trial at 168 days of age and were assigned at random to receive either cow milk or a milk-based formula. Initially, 31 infants had been breast-fed and 21 had been fed formulas. With the feeding of cow milk, the proportion of guaiac-positive stools increased from 3.0% at baseline to 30.3% during the first 28 days of the trial (p less than 0.01), whereas the proportion of positive stools remained low (5.0%) with the feeding of formula. The proportion of guaiac-positive stools among cow milk-fed infants declined later, but for the entire trial it remained significantly (p less than 0.01) elevated. Stool hemoglobin concentration increased markedly with the introduction of cow milk, rising from a mean (+/- SD) of 622 +/- 527 micrograms/gm dry stool at baseline to 3598 +/- 10,479 micrograms/gm dry stool during the first 28 days of ingestion of cow milk. Among infants fed formula, stool hemoglobin did not increase and was significantly (p less than 0.01) less than in the cow milk group. Among infants fed cow milk, the increase in hemoglobin concentration tended to be greater for those who had initially been fed human milk than for those who had initially been fed formulas. Iron nutritional status was not significantly different between the two feeding groups. However, one infant became iron deficient after 4 weeks of ingesting cow milk. We conclude that cow milk feeding leads to increased intestinal tract blood loss in a large proportion of normal infants and that the amount of iron lost is nutritionally important.

Authors+Show Affiliations

Ziegler EE
Department of Pediatrics, University of Iowa, Iowa City 52242.
Fomon SJ
No affiliation info available
Nelson SE
No affiliation info available
Rebouche CJ
No affiliation info available
Edwards BB
No affiliation info available
Rogers RR
No affiliation info available
Lehman LJ
No affiliation info available

MeSH

AnimalsFecesFemaleGuaiacHemoglobinsHumansInfantInfant FoodInfant, NewbornIron DeficienciesMaleMilkNutritional StatusOccult BloodProspective StudiesRandom AllocationReference Values

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

2295949

Citation

Ziegler, E E., et al. "Cow Milk Feeding in Infancy: Further Observations On Blood Loss From the Gastrointestinal Tract." The Journal of Pediatrics, vol. 116, no. 1, 1990, pp. 11-8.
Ziegler EE, Fomon SJ, Nelson SE, et al. Cow milk feeding in infancy: further observations on blood loss from the gastrointestinal tract. J Pediatr. 1990;116(1):11-8.
Ziegler, E. E., Fomon, S. J., Nelson, S. E., Rebouche, C. J., Edwards, B. B., Rogers, R. R., & Lehman, L. J. (1990). Cow milk feeding in infancy: further observations on blood loss from the gastrointestinal tract. The Journal of Pediatrics, 116(1), 11-8.
Ziegler EE, et al. Cow Milk Feeding in Infancy: Further Observations On Blood Loss From the Gastrointestinal Tract. J Pediatr. 1990;116(1):11-8. PubMed PMID: 2295949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cow milk feeding in infancy: further observations on blood loss from the gastrointestinal tract. AU - Ziegler,E E, AU - Fomon,S J, AU - Nelson,S E, AU - Rebouche,C J, AU - Edwards,B B, AU - Rogers,R R, AU - Lehman,L J, PY - 1990/1/1/pubmed PY - 1990/1/1/medline PY - 1990/1/1/entrez SP - 11 EP - 8 JF - The Journal of pediatrics JO - J Pediatr VL - 116 IS - 1 N2 - Because feeding of cow milk causes normal infants to lose increased amounts of occult blood from the gastrointestinal tract, we conducted a prospective trial to measure intestinal blood loss quantitatively and to monitor iron nutritional status. Fifty-two infants entered the trial at 168 days of age and were assigned at random to receive either cow milk or a milk-based formula. Initially, 31 infants had been breast-fed and 21 had been fed formulas. With the feeding of cow milk, the proportion of guaiac-positive stools increased from 3.0% at baseline to 30.3% during the first 28 days of the trial (p less than 0.01), whereas the proportion of positive stools remained low (5.0%) with the feeding of formula. The proportion of guaiac-positive stools among cow milk-fed infants declined later, but for the entire trial it remained significantly (p less than 0.01) elevated. Stool hemoglobin concentration increased markedly with the introduction of cow milk, rising from a mean (+/- SD) of 622 +/- 527 micrograms/gm dry stool at baseline to 3598 +/- 10,479 micrograms/gm dry stool during the first 28 days of ingestion of cow milk. Among infants fed formula, stool hemoglobin did not increase and was significantly (p less than 0.01) less than in the cow milk group. Among infants fed cow milk, the increase in hemoglobin concentration tended to be greater for those who had initially been fed human milk than for those who had initially been fed formulas. Iron nutritional status was not significantly different between the two feeding groups. However, one infant became iron deficient after 4 weeks of ingesting cow milk. We conclude that cow milk feeding leads to increased intestinal tract blood loss in a large proportion of normal infants and that the amount of iron lost is nutritionally important. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/2295949/Cow_milk_feeding_in_infancy:_further_observations_on_blood_loss_from_the_gastrointestinal_tract_ DB - PRIME DP - Unbound Medicine ER -