The Cause of Severe Metabolic Acidosis With Vomiting in a Neonate

We present a 22-day-old male born full term who presented with worsening non-projectile, non-bilious vomiting and failure to thrive (FTT) was admitted the pediatric intensive care unit (PICU) for severe metabolic acidosis an elevated anion gap. Despite changing formula, patient continued have spit-ups after feeds since birth. Before this admission, his worsened every feed, which now forceful along two days of loose stools. Obstructive causes emesis were ruled out upper gastrointestinal series, decision made evaluate organic FTT. Transient resolution symptoms noticed when placed NPO (nothing by os/mouth) briefly. His returned on resuming cow milk-based formula feeds. At time, presumptive diagnosis milk protein allergy (CMPA) made. Positive fecal occult blood supported diagnosis, changed extensively hydrolyzed (eHF). This is case CMPA prolonged FTT presenting report highlights how can lead dehydration increased