Abstract
The aims of this study were to: (1) determine whether replacement of cow’s milk protein with soy resolves Chronic Functional Constipation (CFC); and (2) investigate the effects of cow’s milk β casein A1 and cow’s milk β casein A2 on CFC. Children diagnosed with CFC were recruited to one of two crossover trials: Trial 1 compared the effects of cow’s milk and soy milk; Trial 2 compared the effects of cow’s milk β casein A1 and cow’s milk β casein A2. Resolution of constipation was defined as greater than eight bowel motions during a two week intervention. Thirteen children (18 to 144 months) participated in Trial 1 (6 boys, 7 girls). Nine participants who completed the soy epoch all experienced resolution (p < 0.05). Thirty-nine children (21 to 144 months) participated in Trial 2 (25 boys, 14 girls). Resolution of constipation was highest during the washout epoch, 81%; followed by cow’s milk β casein A2, 79%; and cow’s milk β casein A1, 57%; however, the proportions did not differ statistically. The results of Trial 1 demonstrate an association between CFC and cow’s milk consumption but Trial 2 failed to show an effect from type of casein. Some other component in cow’s milk common to both A1 and A2 milk may be causing a problem in these susceptible children.
Highlights
Chronic functional constipation (CFC), defined as having one bowel motion every 3 to days [1], occurs commonly in children
In Trial 2, we aimed to investigate the effect of cow’s milk β casein A1 and cow’s milk β casein A2 on children with CFC resistant to traditional treatment
Initial clinical assessment of participants showed that a number had symptoms associated with cow’s milk protein allergy (CMPA) or intolerance (CMPI) [13]
Summary
Chronic functional constipation (CFC), defined as having one bowel motion every 3 to days [1], occurs commonly in children. 36% of children who attend a consultation with a paediatrician [2]. A sensitivity to cow’s milk protein (CMP) has been proposed as a possible cause for CFC [3]. A potential link between CMP and constipation was first referred to in the allergy literature as early as the 1950’s [4]. Our systematic review of the literature from 1980 to 2008 assessing the evidence for a causal relationship between. CMP intake and CFC in children found a small body of evidence which was suggestive rather than conclusive [5]. Randomised trials are needed to provide higher level evidence
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