Opinion Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2023; 29(33): 4920-4926
Published online Sep 7, 2023. doi: 10.3748/wjg.v29.i33.4920
Very early onset perinatal constipation: Can it be cow’s milk protein allergy?
Rajalakshmy Arakoni, Hebat Kamal, Sam Xianjun Cheng
Rajalakshmy Arakoni, Department of Pediatrics, University of Florida Shands Children's Hospital, Gainesville, FL 32608, United States
Hebat Kamal, Sam Xianjun Cheng, Department of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Florida Shands Children's Hospital, Gainesville, FL 32608, United States
Author contributions: Cheng SX conceived the idea for the manuscript; Arakoni R and Cheng SX reviewed the literature and drafted the manuscript; Kamal H edited the manuscripts.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sam Xianjun Cheng, MD, MSc, PhD, Attending Doctor, Department of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Florida Shands Children's Hospital, 1600 SW Archer Rd, HD 606, Gainesville, FL 32608, United States. sam.cheng@ufl.edu
Received: April 10, 2023
Peer-review started: April 10, 2023
First decision: June 17, 2023
Revised: July 21, 2023
Accepted: August 15, 2023
Article in press: August 15, 2023
Published online: September 7, 2023
Processing time: 143 Days and 13.9 Hours
Core Tip

Core Tip: Cow’s milk protein allergy (CMPA) is a far lesser known cause of perinatal constipation compared to more frequently considered diagnoses such as Hirschsprung’s, Cystic fibrosis related meconium ileus, etc. The presentation during the perinatal period is considered atypical caused by a non-immunoglobulin E (IgE) mechanism as opposed to the typical presentation caused by an IgE-mediated mechanism. The likelihood of CMPA is significant in the perinatal period, therefore should be considered more often. Here we discuss an alternative pathway for the workup of perinatal constipation focusing on CMPA as an etiology. The use of this pathway can avoid invasive tests among patients.