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. He didn't get any diarrhea from those. Later, we added green pea puree, but after eating it, he had indigestion and lost his appetite. I gave him, and from then on, he started having diarrhea. We've been to the hospital countless times, but he never got better. When he was almost ten and a half months old, the hospital discovered he was allergic to formula. So, we started using Kangmin Golden Amino Acid Formula. At first, there was some improvement, but later, the diarrhea returned intermittently. 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 we're afraid to give him any of it.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 confirmed yet.
The definitive diagnosis of milk allergy requires a food challenge test. For children suspected of having milk allergy, the first step is to avoid milk and dairy products and switch to an amino acid formula or a deep-hydrolyzed protein formula to observe whether symptoms such as diarrhea improve. This period typically lasts 2-4 weeks. If symptoms such as diarrhea do not improve or recur after taking these formulas for 4 weeks, the diagnosis of milk allergy should be questioned.
Of course, during the 2-4 weeks of avoidance, even for children who are ultimately diagnosed with food allergies, diarrhea may still not improve or may recur if they have the following conditions: 1. Incomplete avoidance of potential allergens: Sometimes, allergenic food products such as dairy products are overlooked and not avoided; sometimes, they come into contact with or inhale allergenic foods; sometimes, other allergenic foods may be present without avoidance, such as eggs and egg products; and in some cases, the allergy may not be food-related. 2. Vaccinations. These situations have all been observed clinically, and since your child's diarrhea improved temporarily after switching to an amino acid formula but then recurred, it is indeed important to consider whether the above conditions have occurred.
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 recommendation 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 while strictly avoiding potential allergens; 3. Conduct a diarrhea etiology test.