2021 Volume 35 Issue 3 Pages 214-219
【Introduction】Formula milk for a low birth weight (FM-LBW) is mainly used in the neonatal specific intensive care unit because of its excellent nutritional value.
【Case】A 4-month-old boy with bradycardia noted from during the fetal period. Decreased fetal movement and fetal hydrops were observed 2 days before expected date of birth, and the patient was born by an emergency Caesarean section. After birth, the patient was diagnosed with neonatal asphyxia due to bradycardia and entered a neonatal specific intensive care unit. Milk was started at 10 days of age with an improvement in his general condition. He had a fever at 19 days of age and had a positive blood culture test. He was diagnosed with sepsis and started antibiotic treatment. He was changed to FM-LBW diet at 32 days of age. After the change, gastrointestinal symptoms such as abdominal distension and vomiting, increased fever, an inflammatory reaction with no response to antibiotics, and marked increase in the peripheral blood eosinophils (25.2%) were observed. We suspected a non-IgE mediated the gastrointestinal food allergy and terminated FM-LBW diet as a removal test and changed to breast milk or milk. Then, gastrointestinal symptoms and fever improved, and the peripheral blood eosinophils rapidly decreased.
【Discussion】Although the clear mechanism of allergic symptoms in this case is unknown, it was considered that the high amount of milk protein contained in FM-LBW was the cause of the induction of the symptoms.
