Letters to the Editor

Cow's Milk Protein Intolerance and Childhood Constipation


Am Fam Physician. 2003 Sep 15;68(6):1016.

to the editor: In the March 1, 2003 issue of American Family Physician, the department “Clinical Evidence”1 addressed the effects of various treatments for childhood constipation. The author only briefly touches on the factor of dietary factors by stating that there are “no randomized controlled trials on the effects of increasing dietary fiber in children.”

In my experience, intolerance of cow's milk is a significant cause of childhood constipation. A popular pediatric textbook2 lists excessive milk intake as a cause of constipation in children. A double-blind study3 of 65 children with chronic constipation who failed to respond to laxatives showed resolution of the constipation in 66 percent of the subjects while on soy milk.


1. Rubin GP. Childhood constipation. [Clin Evidence] Am Fam Physician. 2003;67:1041–2.

2. Sondheimer JM. Gastrointestinal tract. In: Hay WW. Current pediatric diagnosis & treatment. 15th ed. Norwalk, Conn: Appleton & Lange, 2001:561.

3. Iacono G, Cavataio F, Montalto G, Florena A, Tumminello M, Soresi M, et al. Intolerance of cow's milk and chronic constipation in children. N Engl J Med. 1998;339:1100–4.

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This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.



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