Patient's question:
My child was weaned when he was eight months old. Around seven months, we started adding formula and solid foods, beginning with apple puree, rice powder, pigeon egg yolk, etc., and he never had diarrhea. Later, we added green pea puree, but he couldn’t digest it and became picky about food. I gave him, and from then on, he had diarrhea. We’ve been to the hospital countless times, but it never got better. When he was almost ten and a half months old, the hospital diagnosed him with a formula allergy. So, we started using Kangminkin Amino Acid Formula. At first, there was some improvement, but later it became inconsistent, with frequent loose stools. Now that he’s one year old, his height and weight are both below standard, and we don’t know what to do. We have a lot of medicine at home but don’t dare to give him any. His stools are sometimes watery, sometimes like eggshells, with mucus but no blood streaks. His spirits and appetite are good, though his height has increased by 4 cm, but his weight hasn’t grown. He previously had no eczema, though he had digestive issues once when he was three months old. The formula allergy was confirmed through blood tests and skin prick tests. We’ve been using Kangminkin for a month now, and since switching to amino acid formula, he hasn’t had any contact with other milk or dairy products. He hasn’t been vaccinated and is now eating Kangminkin formula with added porridge. Neither parent has a history of allergies.Doctor's answer:
I'm sorry, based on the information you provided: Personally, I believe the cause of the child's diarrhea is still unclear. Although blood allergen testing and skin prick tests suggest milk allergy, from the overall condition of the child, especially the improvement in diarrhea after avoiding dairy protein, the diagnosis of milk allergy cannot be established yet. The definitive diagnosis of milk allergy requires a food challenge test. The first step for a child suspected of having a milk allergy is to avoid milk and dairy products and switch to an amino acid formula or a deep hydrolyzed protein formula to observe the improvement in diarrhea and other symptoms. This period needs to last for 2-4 weeks. If the diarrhea and other symptoms do not improve or recur after taking the above formulas for 4 weeks, the diagnosis of milk allergy should be questioned.Of course, during the 2-4 weeks of avoidance, even if a child is ultimately diagnosed with a food allergy, diarrhea may still not improve or recur if the following conditions are present: 1. Incomplete avoidance of potential allergens: Sometimes, products of the allergenic food, such as dairy products, are also overlooked and not avoided; sometimes, the child is exposed to or inhales the allergenic food; sometimes, other allergenic foods may coexist without avoidance, such as eggs and egg products; and sometimes, the allergy may not be food-related. 2. Vaccinations. These situations have all occurred clinically, and the fact that your child's diarrhea improved temporarily after switching to an amino acid formula but then recurred again definitely warrants attention to the above possibilities.
Another common cause of prolonged diarrhea in children is infection, but there is currently a lack of evidence, especially in terms of etiology.
Therefore, my advice is: 1. Carefully recall whether any of the situations mentioned above occurred during the avoidance period; 2. Continue using the amino acid formula for 7 days and strictly avoid potential allergens; 3. Conduct a diarrhea etiology test.