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High-protein goat’s milk diet identified through newborn screening: clinical warning of a potentially dangerous dietetic practice

Published online by Cambridge University Press:  24 July 2017

Evelina Maines ,
Giorgia Gugelmo ,
Elisa Tadiotto ,
Angelo Pietrobelli ,
Natascia Campostrini ,
Andrea Pasini ,
Florina Ion-Popa ,
Monica Vincenzi ,
Francesca Teofoli  and
Marta Camilot
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Evelina Maines*
Affiliation:
Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Giorgia Gugelmo
Affiliation:
Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Elisa Tadiotto
Affiliation:
Pediatric Clinic, ‘Giambattista Rossi’ Hospital, University of Verona, Verona, Italy
Angelo Pietrobelli
Affiliation:
Pediatric Clinic, ‘Giambattista Rossi’ Hospital, University of Verona, Verona, Italy
Natascia Campostrini
Affiliation:
Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Andrea Pasini
Affiliation:
Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Florina Ion-Popa
Affiliation:
Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Monica Vincenzi
Affiliation:
Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Francesca Teofoli
Affiliation:
Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Marta Camilot
Affiliation:
Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Andrea Bordugo
Affiliation:
Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Piazzale L.A. Scuro 10, 37134 Verona, Italy
*
* Corresponding author: Email evelina.maines@gmail.com
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Abstract

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Objective

Breast-feeding is an unequalled way of providing optimal food for infants’ healthy growth and development and the WHO recommends that infants should be exclusively breast-fed for the first 6 months of life. For mothers who are unable to breast-feed or who decide not to, infant formulas are the safest alternative. Despite recommendations, it is possible that parents make potentially harmful nutritional choices for their children because of cultural beliefs or misinformation on infant nutrition. We describe a possible health risk of not breast-feeding, highlighting a potentially dangerous dietetic practice.

Design/Setting/Subjects

We report the case of a newborn who was fed with undiluted goat’s milk because her mother could not breast-feed and was not aware of infant formulas.

Results

The dietary mistake was detected because of a positive expanded newborn screening result, characterized by severe hypertyrosinaemia with high methionine and phenylalanine levels, a pattern suggestive of severe liver impairment. The pattern of plasma amino acids was related to a goat’s milk diet, because of its very different composition compared with human milk and infant formula.

Conclusions

Our experience demonstrates that, when breast-feeding is not possible or is not exclusive, infants may be at risk of dangerous nutritional practices, including diets with very high protein content, such as a goat’s milk diet. Families of not breast-fed infants may need appropriate advice on safe alternatives for infant nutrition to avoid the risks of inappropriate diets.

Keywords

Goat’s milkHypertyrosinaemiaExpanded newborn screeningInfant nutrition

Information

Type
Short Communication
Information
Public Health Nutrition , Volume 20 , Issue 15 , October 2017 , pp. 2806 - 2809
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Copyright
Copyright © The Authors 2017 

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