NOVEL PLANT-BASED PEDIATRIC FORMULA ALTERNATIVE FOR MANAGEMENT OF NON-IGE-MEDIATED FOOD ALLERGIES: A CASE STUDY

Abstract

<h3>Introduction</h3> Traditional management of food protein-induced allergic proctocolitis (FPIAP) includes use of extensively hydrolyzed or elemental formula and/or the removal of dairy and soy from maternal diet for breastmilk-fed infants. This case outlines use of a novel plant-based pediatric formula in an infant diagnosed with dairy and soy-protein FPIAP. <h3>Case Description</h3> At 2 weeks of age, P presented with a dusky, distended belly and stridor within 24 hours of initial exposure to a polymeric cow milk-based infant formula. Following standard protocol for suspected FPIAP, he was transitioned to an elemental formula and his mother was placed on an elimination diet. Breastmilk was re-introduced after 10 days of elimination diet with formula supplementation. He was transitioned to supplemental extensively-hydrolyzed casein formula at 6 months. At age 10 months, due to U.S. infant formula shortages, P transitioned successfully to a novel plant-based pediatric formula sourced from almonds and buckwheat that is free of soy, rice, and pea proteins. P failed cow's milk challenge and subsequently pea-protein milk challenge upon turning 12 months, which both induced repeated gastrointestinal distress. Symptoms resolved upon re-introduction of the novel plant-based formula. <h3>Discussion</h3> This case demonstrates that an alternative protein-sourced formula has the potential to serve as a safe alternative therapy strategy to address patients with FPIAP unable to exclusively breastfeed and/or tolerate traditional formulas. These findings justify the need for further development and demonstration in a clinical setting of an alternative protein-sourced infant formula to be used in the standard management of food allergy disorders.