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September 5, 1977

Milk-Curd Bowel Obstruction in the Newborn Infant

JAMA. 1977;238(10):1050-1052. doi:10.1001/jama.1977.03280110054024

IN 1969, Cook and Rickham1 first reported a syndrome of neonatal intestinal obstruction due to inspissated milk curds. This new entity had not been seen before in more than 600 cases of bowel obstruction in newborn infants admitted to the Liverpool Neonatal Surgical Center and had not been previously described in the literature. They found that the obstruction occurred primarily in premature infants in whom high-caloric feedings were begun shortly after birth. In all eight cases, the babies were well at birth, passed normal meconium stools, and began receiving feedings of either reconstituted powdered milk or diluted milk-concentrate.

Altered stools and then milk stools were passed until low small-bowel obstruction suddenly developed at ages 5 to 14 days. Studies indicated that milk-curd obstruction resulted from a combination of early feeding of high-caloric milk and the decreased ability of the infant to absorb proteins and amino acids. Of interest was