Pascale Soulaines

Fecal calprotectin: cutoff values for identifying intestinal distress in preterm infants.

This study aimed to determine cutoff levels for fecal calprotectin as a marker of intestinal distress in preterm neonates. A total of 126 infants born at a median gestational age of 33 weeks (range 25.7–35 weeks) were enrolled. Samples (n = 312) were collected weekly from the end of the first week of life until the end of the first month and if any gastrointestinal event occurred. Receiver operating characteristic curves analysis gave cutoff values of 363 μg/g (sensitivity 0.65, specificity 0.82) and 636 μg/g (sensitivity 0.72, specificity 0.95) for the development of mild or severe enteropathy.

Atopy patch test for early diagnosis of cow's milk allergy in preterm infants.

Atopy patch test may help early diagnosis of cow-milk allergy in preterm infants. In the retrospective analysis of 5 girls and 9 boys, born at 31 ± 2 (mean ± SD) weeks of gestation and presenting digestive symptoms at age 42 ± 18 days, 10 had a complete recovery following the shift to an exclusive feeding with an amino acid–based formula. Cow-milk–skin prick tests and specific immunoglobulin E were always negative, whereas the atopy patch test was positive in 7 of the 10 infants with complete recovery.

Safety of a new amino acid formula in infants allergic to cow's milk and intolerant to hydrolysates

Objectives: Amino acid–based formulas (AAFs) are recommended for children with cows-milk allergy (CMA) failing to respond to extensively hydrolysed formulas (eHFs). We evaluated the effects of a new thickened AAF (TAAF, Novalac), containing a pectin-based thickener, and a reference AAF (RAAF, Neocate) on allergy symptoms and safety, through blood biochemistry analysis and growth. Methods: Infants (ages < 18 months) with CMA symptoms failing to respond to eHFs were randomised in a double-blind manner to receive TAAF or RAAF for 3 months. All of the infants were then fed TAAF for 3 additional months. Paediatric visits occurred at 1, 3, and 6 months. Blood samples were collected at inclusion and 3 months. Results: Results at 1 month were previously described. The 75 infants with proven CMA and eHF intolerance tolerated their allocated formula. At 3 months, the dominant allergic symptom had disappeared in 76.2% of the infants with TAAF and in 51.5% of the infants with RAAF (P = 0.026). The Scoring Atopic Dermatitis Index significantly improved more with TAAF than with RAAF (−27.3 ± 2.3 vs −20.8 ± 2.2, P = 0.048). Of the infants, 92.9% had normal stools (soft or formed consistency) with TAAF vs 75.8% with RAAF (P = 0.051). More infants in TAAF group had better quality of nighttime sleep (P = 0.036) and low frequency of irritability signs (P < 0.001). With both formulas, all of the biochemical parameters were within normal ranges. There were no differences between the 2 groups in any of the anthropometric z scores. Conclusions: The new TAAF was tolerated by all of the infants with CMA and intolerance to eHFs. Anthropometric and clinical data showed that both formulas were safe.