SEVERAL FACTORS are known to contribute to the development of hypochromic microcytic anemia in infants, eg, prematurity, multiple births, and inadequate dietary iron. Recently attention has focused on the possible etiological role of occult gastrointestinal bleeding in certain infants. Although a greater fecal blood loss has been demonstrated in infants with hypochromic microcytic anemia than in controls, using radioisotopic techniques, the cause of this phenomenon has not been elucidated.1,2
On the basis of previous studies3 which demonstrated a high incidence of positive guaiac tests on stools, increased concentrations of plasma proteins in gastric juice, and multiple precipitins in high titer to whole cow's milk, it was postulated that the ingestion of whole cow's milk could be responsible for these signs of gastrointestinal dysfunction. It was further speculated that a mechanism of milk-induced gastrointestinal blood loss might lead to hypochromic microcytic anemia in some subjects.
The present study was
Wilson JF, Heiner DC, Lahey ME. Milk-Induced Gastrointestinal Bleeding in Infants With Hypochromic Microcytic Anemia. JAMA. 1964;189(7):568–572. doi:10.1001/jama.1964.03070070040010