Back in the 1950s, it was suggested that some cases of constipation among children might be due to the consumption of cow’s milk. But it wasn’t until 40 years later that it was finally put to the test. We used to think that most chronic constipation in infants and young children was all in their head—they were “anal retentive”—or had some intestinal disorder, but a group of Italian researchers studied 27 consecutive infants who showed up in their pediatric gastroenterology clinic with chronic “idiopathic constipation” (meaning they had no idea what was causing it), and tried removing cow’s milk protein…
Back in the 1950s, it was suggested that some cases of constipation among children might be due to the consumption of cow’s milk. But it wasn’t until 40 years later that it was finally put to the test. We used to think that most chronic constipation in infants and young children was all in their head—they were “anal retentive”—or had some intestinal disorder, but a group of Italian researchers studied 27 consecutive infants who showed up in their pediatric gastroenterology clinic with chronic “idiopathic constipation” (meaning they had no idea what was causing it), and tried removing cow’s milk protein from their diet.
Within three days on a cow’s milk protein-free diet, 21 out of the 27 children were cured. There were clinical relapsea during two subsequent cow milk challenges, meaning when they tried giving the children back some cow’s milk, the constipation reappeared within 24 to 48 hours. The subjects came back after a month and stayed cured, and their eczema and wheezing went away, too! The researchers concluded that many cases of chronic constipation in young children—more than three quarters it seemed, may be due to an underlying cow’s milk protein allergy.
Chronic constipation is a common problem in children, for which fiber and laxatives are prescribed. If those don’t work, several laxatives at progressively higher dosages can be used, and that still may not work. Five years later, a considerable number of kids are still suffering. In fact, chronic constipation may even extend into adulthood. To cure the disease in just a few days by eliminating cow’s milk was a real breakthrough.
But it was an open trial, meaning not blinded or placebo-controlled. We didn’t have such a trial until a landmark study was published in the New England Journal of Medicine—a double-blind, crossover study, comparing cow’s milk and soy milk. The study enrolled 65 kids suffering from chronic constipation, all previously treated unsuccessfully with laxatives; 49 had anal fissures and inflammation and swelling. The researchers gave them either cow’s milk or soy milk for two weeks and then switched it around.
In two thirds of the children, constipation resolved while they were receiving soy milk, and the anal fissures and pain were cured. None of the children receiving cow’s milk had a positive response. In the 44 responders, the relation with cow’s milk protein hypersensitivity was confirmed in all cases by a double-blind challenge with cow’s milk. All those lesions, including the most severe anal fissures, disappeared on a cow’s milk-free diet, yet reappeared within days after the reintroduction of cow’s milk back into their diets.
This may explain why children drinking more than a cup of milk a day may have eight times the odds of developing anal fissures. Cutting out milk may help cure anal fissures in adults, too. Cow’s milk may also be a major contributor to recurrent diaper rash as well.
Why does removing cow’s milk treat these conditions? Studies that have looked at biopsy tissue samples in patients with chronic constipation because of cow’s milk protein hypersensitivity have found signs of rectal inflammation, suggesting that cow’s milk protein was inducing an inflammatory response.
Studies from around the world have subsequently confirmed these findings, curing up to 80 percent of kids’ constipation by switching to soy milk or rice milk. A common problem with the studies, though, is when they switched kids from cow’s milk to non-dairy milk, the kids could still have been eating other dairy products. That is, they didn’t control the background diet…until recently. A 2013 study (highlighted in my video, Childhood Constipation and Cow’s Milk, got constipated kids off all dairy products and 100 percent were cured, compared with 68 percent in the New England Journal study.
Isn’t this amazing? I just kept thinking, “why didn’t I learn this in medical school?” Is the dairy lobby so persuasive that a cheap, simple, safe, life-changing intervention like this remains buried?
Until now!
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Make sure to check out tomorrow’s video: Treating Infant Colic by Changing Mom’s Diet.
Avoiding dairy may be important for infant health too. Watch my 3-part video series:
Then the effects on adolescents and beyond:
In health,
Michael Greger, M.D.
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Image Credit: Melissa Wiese / Flickr
Source: A Simple Yet Neglected Cure for Childhood Constipation : Nutrition Facts
