Powdered infant formula containing poorly soluble powdered milk may form amorphous globules within the intestine with bowel obstruction. Infants with decreased intestinal motility may be at increased risk.

Clinical features:

(1) usually involves a premature infant, but may occur in a full-term infant who has had surgery or been ill

(2) presents with evidence of intestinal obstruction

(3) history of being fed on a formula with a high concentration of powdered milk

(4) may have palpable intestines

(5) evacuation of hardened, putty-like curd pellets after barium enema


Radiographs of abdomen:

(1) opaque (gray to white) amorphous, round to elongated intraluminal masses surrounded by a zone of air and lacking a fluid level

(2) barium enema shows a narrow colon with rounded intraluminal filling defects


Differential diagnosis:

(1) meconium ileus (frothy masses or non-opaque ground glass appearance on radiographs)

(2) intestinal atresia



(1) A Gastrografin enema may be effective in relieving the obstruction.

(2) Some infants may develop an intestinal perforation and require surgical repair.

To read more or access our algorithms and calculators, please log in or register.