Effect Of Different Interventions On Prognosis Of Breast-fed Infants With Food Protein-Induced Allergic Proctocolitis

Objective To evaluate the effect of different feeding in early stages on prognosis,which is included remission of clinical symptoms,immune tolerance and growth,of breast-fed infants with food protein-induced allergic proctocolitis(FPIAP).Methods This is a randomized controlled trial.67 breast-fed infants who went to Shenzhen maternity and child healthcare hospital between January 1,2021 and August 31,2022 and were diagnosed with FPIAP were enrolled in the study.They were divided into 2 groups based on the feeding ways:breast feeding group(n=24)and hyposensitivity formula(extensively hydrolyzed formula/amino acid formula)group(n=43).Hyposensitivity formula group fed on extensively hydrolyzed formula or amino acid formula instead of breast in the first two weeks,then,breast-milk was gradually added in the rest two weeks,at the same time,allergenic food protein was restricted from the diet of the breastfeeding mother.A month later,hyposensitivity formula group turn into breast feeding with the need for dietary restrictions.By contrast,the other group were breast fed with maternal elimination of allergenic food from beginning to end.We compared the differences in clinical symptoms remission after a month and three months,immune intolerance,and growth.Results The median age at onset for FPIAP was 65(44,97)days.The allergic symptoms remission rate after a month of hyposensitivity formula group was 90.70%,the rate of breast feeding group was 50.00%.The allergic symptoms remission rate after 3 months of hyposensitivity formula group was 97.67%,the rate of breast feeding group was 62.50%.The allergic symptoms remission rates after a month and 3 months of the two groups had statistically significant.The incidence rate of hyposensitivity formula group occurred solid food allergy was 53.49%,the rate of breast feeding group was 33.33%.While,the incidence rate of the two groups occurred solid food allergy had no statistically significant difference.The immune tolerance rate at one year old of hyposensitivity formula group was 57.58%,the rate of breast feeding was 20.00%.The immune tolerance rates at one year old of two groups had statistically significant difference.There was no statistically significant difference in the averages of weight,height,and head circumference at one month,three months,six months,twelve months between hyposensitivity formula group and breast feeding group.The weight,height,and head circumference increase in each stage had no significant difference between the two groups.There was 1 infant of breast feeding occurred malnutrition,while there was 1 infant of hyposensitivity formula group.The incidence rate of malnutrition had no significant difference between the two groups.Conclusion FPIAP usually occurs in infants.The median age at onset for breast-fed infants with FPIAP was 65(44,97)days.Hyposensitivity formula contributes to remission of allergic symptoms.Short-term feeding with hyposensitivity formula during the acute phase have a contribution to immune tolerance.The probability of term breast-fed infants with FPIAP getting malnutrition at 12 months is 4.08%.