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Gastrointestinal Milk Intolerance of Infancy-Reply

STUART BEREZIN, MD; STEVEN M. SCHWARZ, MD; MARK GLASSMAN, MD; LEONARD J. NEWMAN, MD; MARIANNA DAVIDIAN, MD
Am J Dis Child. 1990;144(1):17. doi:10.1001/archpedi.1990.02150250017013.
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In Reply.—We appreciate the pertinent and provocative comments of Dr Wenner regarding our recent article in AJDC. Indeed, we agree with several of Dr Wenner's comments. We must emphasize, however, that the purpose of this article was not to suggest that repeated colonoscopies are a cost-effective or even preferred method of following up infants with suspected milk protein intolerance. Rather, our aim was to establish a rapid and more definitive method of diagnosis than previously available.

Our feeling is that in an infant with hematochezia and negative stool culture findings, an initial colonoscopy can identify the characteristic findings of milk-induced colitis, as stated in our article. Once a diagnosis is established, a follow-up (with a milk protein challenge) can be performed using stool hemoccult examinations rather than a formal colonoscopy. Unfortunately, this was not clear in our article.

We disagree with Dr Wenner's proposal for the diagnosis of milk-induced

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