food protein allergy blood in stool

More than 90% of hematochezia caused by food protein allergy are mild to moderate symptoms and will not affect the child's growth and development. Breastfed babies can be relieved by the mother's intervention to avoid allergens, and there is no need to stop breastfeeding rashly.； Only less than 10% of severe allergy cases require replacement of deeply hydrolyzed or amino acid formula powder under the guidance of a doctor. The vast majority of children can tolerate common allergens on their own after the age of 1-3 without leaving any sequelae.

Not long ago, I met a mother in the clinic. She came in with her 6-month-old exclusively breastfed baby. Her eyes were swollen like walnuts, and she was holding three or four bloody diapers in her hands. She said that her mother-in-law had packed her things at home to express the breast milk and throw it away. She had to give the baby imported anti-allergic milk powder, saying that if she continued to breastfeed, the baby would be ruined. I checked the baby's growth curve, and it was 2 percent higher than the median. He was able to eat and laugh, and even reached out to grab the cartoon sticker in my hand. The regular stool test showed positive occult blood and a small number of white blood cells, but no pus cells and no signs of infection. It is typical of proctocolitis induced by mild to moderate food protein allergy, which is commonly known as allergic hematochezia.

Many people don’t understand why they have blood in their stools due to allergies? To put it bluntly, the baby's intestinal mucosal barrier has not yet grown "strong". The macromolecule proteins in foods such as milk, eggs, and seafood that the mother eats will enter the baby's intestines through breast milk. The immune cells have never seen these "outsiders" and directly attack them as enemies. The intestinal mucosa is broken and the blood is excreted mixed with the stool. It is the red blood streaks and dark red blood spots that everyone sees. Sometimes they are mixed in the mucus and cannot be found without looking carefully.

There are actually two different tendencies in the industry to deal with this kind of situation. One view advocates directly switching to special formula powder. The advantage is that the effect is quick, and blood in the stool usually disappears in 3-5 days. The disadvantage is that it is a pity to stop breastfeeding, and many babies refuse to eat the bitter taste of deeply hydrolyzed powder. Feeding it is simply a disaster for the whole family. If it is eaten for a long time, the active antibodies in breast milk will be reduced. Another view is to give priority to retaining breast milk and allow mothers to strictly avoid high-risk allergens. The effect is slower, usually taking 1-2 weeks to completely disappear, but it is better for the long-term immune development of the baby. I usually give parents a thorough explanation of the pros and cons of both options. As long as the baby has no problems with growth and development and does not have severe eczema or frequent vomiting or other accompanying symptoms, I will give priority to recommending that the mother give it a try first. This was the case with my best friend's baby last year. She gave up milk, cakes, milk tea and other milk-containing products for 2 weeks, and the baby's bloodshot stools disappeared in a week. Now the baby is 14 months old and can eat eggs and yogurt normally without any problems.

To be honest, I have seen too many pitfalls. For example, when I see white blood cells, I give my baby antibiotics. This is really a big misunderstanding. Allergy-induced inflammation of the intestinal mucosa can also produce white blood cells. It is not a bacterial infection at all. Taking antibiotics kills all the good bacteria in the intestines, and the intestinal mucosa is repaired more slowly, which in turn prolongs the process. There are also many parents who buy a box of anti-allergic probiotics worth hundreds of yuan. There is currently no unified conclusion in the academic community on whether probiotics can relieve allergies and bloody stools. Only a few studies have shown that specific strains such as Lactobacillus rhamnosus GG may have some auxiliary effects. If you really want to buy it, choose one with a clear strain number. If it doesn’t work for two weeks, stop immediately. Don’t pay the IQ tax.

But don’t just think that all blood in the stool is an allergy. If your baby has a lot of bright red blood and jam-like stools, and is also in low spirits, crying, and vomiting severely, don’t hesitate to go directly to the emergency department. First rule out more urgent problems such as intussusception and anal fissure, and don’t delay things.

In fact, to put it bluntly, food protein allergy and blood in the stool are a very common episode in the development of babies, just like a toddler who falls over. There is no need to stop breast-feeding as soon as it is faced with danger, and don’t be so worried that you have diarrhea for half a month without going to the hospital for evaluation. Finding a reliable pediatric gastroenterologist is much more effective than scrolling through Baidu all night and being so scared that you can’t sleep.