Rice milk diet and kwashiorkor in an infant with eczema
What it found
An infant fed only rice milk to treat severe eczema developed kwashiorkor, with swelling, low blood protein and poor weight gain.
The child recovered after being switched to cow's milk with nutritional guidance.
What they found
Studies in people
Swelling and low protein
After about 2 months on the restricted diet, the child developed swelling in his feet, legs and upper arms, and passed less urine. On admission his total protein was 3 g/dl and albumin 1.365 g/dl.
Poor weight gain
He weighed 7.600 Kg from the age of six months up to 1 year, so he did not gain weight over that time.
Anaemia and clotting problems
He was found to be anaemic with a haemoglobin of 5.7 g/dl and had abnormal clotting tests. He was given albumin, a red blood cell transfusion, oral iron, folic acid and vitamin K.
Recovery on cow's milk
The child was immediately fed cow's milk, which was well tolerated, and with guidance from a nutritionist the swelling gradually resolved. By day 10, total protein, albumin and clotting tests had normalised.
Lasting low calcium
Because of a long lasting low blood calcium level of 7.3 mg/L, he developed demineralisation of his teeth that persisted at follow up visits up to 2 years of age.
Eczema and allergy tests
Eczema improved and scratching was less evident with topical treatment. A skin prick test was negative to milk and egg allergy.
What the authors conclude
“The use of rice milk resulted in hypoalbuminemia and poor weight gain.”
Also in their conclusions
- They say this case reinforces the concept that hypoallergenic diets should be managed by allergists with experience in food allergies.
- They advise that consultation and consensus should be achieved between specialists in pediatrics, allergy, nutrition and endocrinology before adopting severely restrictive diets.
- They state that the choice of an elimination diet should be limited to children with moderate to severe eczema not controlled by topical steroids, under strict nutritional surveillance.
How it was done
The authors say that using rice milk without nutritional counselling to treat eczema is still a continuing poor practice, even though severe low blood protein from rice milk has been described before.
They describe one exclusively breastfed boy who developed eczema at 4 months. From 6 months he was fed rice milk, fruits, rice, poultry and vegetable broth, and later only rice milk, until he was hospitalised around 1 year old.
What it can’t tell you
- This is a single case report, so it cannot show that rice milk diets cause kwashiorkor in all infants.
- It cannot show how often this problem happens or which children might be most at risk.
Who paid
- Authors work at
- Anna Meyer Children's University Hospital, Italy; University of Florence, Italy
The paper
- Title
- A kwashiorkor case due to the use of an exclusive rice milk diet to treat atopic dermatitis
- Type
- Case report
- Evidence
- Studies in people
- Summarised from
- Full text
- Licence
- CC BY. Words in quotation marks are the authors’; the rest is our summary.
- Cite
- Mori F, Serranti D, Barni S, et al (2015). A kwashiorkor case due to the use of an exclusive rice milk diet to treat atopic dermatitis. Nutrition journal. doi:10.1186/s12937-015-0071-7Free full textPubMed 26293684DOI
Summary written 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error