Milk Soy Protein Intolerance
Question
My 4-month-old was diagnosed with MSPI (milk soy protein intolerance) at 1 month and my wife is nursing. We have tried the diet for three months now and have had varying degrees of success. The troubling thing is that after seeing our pediatrician almost every week until three months, and seeing a GI specialist, our daughter still has bloody stools. I'm concerned about Crohn's disease.
Dr. Greene`s Answer:
Bloody stools (and fussiness) are often the symptoms that lead people to suspect MSPI. Breastfeeding is great for kids with MSPI, but be aware that they can also be sensitive to several foods in the mother’s diet. Many kids who are allergic to milk protein are also allergic to soy protein. Some are also allergic to egg, peanuts, wheat or corn–though this is much less common.
With the continued blood, you want to be sure that your daughter is not anemic. If anemia were going to be a problem anytime soon, you would expect to see it by now. Regardless, continue the relationship with the GI doctor. If a child with MSPI continues to have blood stools despite mother being on a restricted diet for three months, some GI doctors may recommend a trial of elemental formula (such as Alimentum or Nutramigen) prior to pursuing more invasive tests such as colonoscopy.
Crohn’s has two age peaks when it most commonly occurs. Once is in the teens and the other is in mid adulthood. It can happen earlier in childhood, but only rarely. Keeping an eye out for it is one reason to stay in touch with the GI doctor, but food allergies–temporary food allergies–are dramatically more common in the situation you have described. The incidence of Crohn’s disease is only three or four per 100,000 people, and most of those are far older. The incidence of food allergies is more like six in 100–and often in babies.