• Four children experienced kwashiorkor six weeks to six months following the introduction of a low-protein, high-fat, nondairy creamer into their diets. In all cases, the milk substitute eventually became their sole nutritional source and resulted in hypoproteinemia, edema, and hepatic abnormalities. All patients had been given the milk substitute in an attempt to control suspected milk protein sensitivity. Only one of the four patients was subsequently shown to have cow's milk sensitivity. All had complete resolution of symptoms within six weeks following institution of a nutritionally adequate diet.
(Am J Dis Child 135:21-23, 1981)