Diseases of the Entero-Mammary Circle: A New Clinical Entity

Background: Gastrointestinal malabsorption of proteins from the diet of the mother can induce diseases in breast fed infants. The malfunction of the gastrointestinal tract (GI) of the mother is the basic process causing this disease. This new entity is under the scope of “diseases of the entero-mammary circle” (DEMC). Proteins different from homologues proteins of the breast milk, present in breast milk offered to the infant develops food allergy with clinical manifestation in different organs of the newborn and infant. Here we describe the most relevant clinical symptoms associated to this new entity the DEMC.

Methods: From January 2015 to January 2021, 100 charts from infants, age 0 to 6 months, were randomly selected from our clinic of Pediatric Gastroenterology and Food Allergy at Santa Casa da Misericordia do Rio de Janeiro, Rio de Janeiro, Brazil. The inclusion criteria were: 1) To be exclusively breast fed since birth and 2) Diagnosis of food allergy through strict diet to the mother without cow's milk, egg, soy and wheat protein and subsequent oral challenge with ingestion of the seafood by the mothers and recurrence of gastrointestinal, respiratory or dermal symptoms by oral challenge positive. The exclusion criteria were the use of other any food besides the breast milk.

Results: The onset of symptoms in the patients studied starts early in life. In the GI system the prevalent clinical symptoms were blood in stool, gastro-esophageal reflux, abdominal distention, abdominal pain, diarrhea, constipation, bulky stools, flatus and vomiting, colic’s and nauseas and hiccups. In the respiratory system of the patients, the clinical disturbance was snoring and rhinitis, sinusitis, excess of mucus, chronic cough, and asthma. In the skin system, was prevalent the pallor, atopic eczema, eczema of folds, erythema of the cheeks, per oral erythema and seborrheic dermatitis. Related to the central nervous system we found sleep disorder, insomnia, irritability, and lethargy.

Conclusion: The present study was developed to explore the broad spectrum of the DEMC, presented as different clinical pictures in infants, exclusively breast fed, compromising all systems such the GI tract, the skin, the respiratory system, and the central nervous system.