Lack of lactobezoars in infants given predominantly whey protein formulas

R. L. Schreiner, M. S. Brady, J. A. Ernst and J. A. Lemons

Lactobezoars have been reported with increasing frequency in low-birth-weight infants. The etiology of a lactobezoar is not well understood and is probably multifactorial. During a 2 1/2-year period, 29 of 442 infants weighing less than 2,000 g who were fed casein-predominant formulas had lactobezoars. During the subsequent 14-month period, 223 infants weighing less than 2,000 g were fed a whey-predominant formula, and none had lactobazoars. There have been no reports of lactobezoars in infants fed human milk or whey-predominant formulas. It would appear that the presence of casein as the predominant protein is necessary for the development of a lactobezoar.