Unusual presentation of cow's milk protein allergy in a neonate

Cow's milk protein allergy is the most common food protein allergy in children. We report a neonate on breast feeds and formula feeds presenting on day 9 of life with blood in stools, anemia, shock, respiratory failure with multiorgan dysfunction, and recovered with intensive care. Colonoscopy and biopsy confirmed the diagnosis as allergic colitis. Neonate improved with cow's milk protein-eliminated diet. Food protein allergy can present with protean signs and symptoms; high index of suspicion is needed for the prompt early diagnosis.