CHANGING PATTERN OF COW'S MILK INTOLERANCE: An Analysis of the Occurrence and Clinical Course in the 60s and mid‐70s

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Abstract
The rapid changeover to commercial adapted infant formulae which took place in Finland between 1973-1975 was studied as a factor in the occurrence of severe intestinal cow''s milk intolerance (CMI). Of infants treated for CMI in 1962-1973, 93% (25/27) were on homemade or unadapted formulae. The admission rate for CMI in these years was 0.22/1000 liveborn infants breast fed < 6 mo. During 1974-1977 the corresponding figure was 0.56, with 85% of the patients (18/26) on adapted cow'' milk formulae. The patients treated before 1974 had a longer symptomatic period before admission, greater growth retardation and more severe intestinal damage than those seen during and after 1974. This may reflect the increasing awareness of CMI by laymen and the medical profession. In the history of 2/3 of the patients at least 1 of the following conditions was noted: non-breast feeding, infectious gastroenteritis, prematurity, 21-trisomy, prior intra-abdominal surgery, Hirschsprung''s disease and atopic disease in family members. The long follow-up averaging over 4 yr revealed 4 patients with celiac disease. In 1 of these the proximal jejunal mucosa was normal after 2 yr on gluten-containing diet, but he showed a mucosal relapse as late as 2-4 yr on normal diet.