Researchers studied six babies who developed a rare condition called acrodermatitis enteropathica, which happens when the body doesn’t get enough zinc. This condition causes severe skin rashes, diarrhea, and frequent infections. Most of the babies were exclusively breastfed and born early. The study found that breast milk loses zinc after the first two months, which explains why symptoms appeared around 3-5 months old in breastfed babies. All six babies improved quickly once they received zinc supplements. This research helps doctors recognize the warning signs of this serious but treatable condition.
The Quick Take
- What they studied: A rare condition where babies don’t absorb enough zinc from food, causing serious skin problems, infections, and digestive issues
- Who participated: Six babies between 5-13 months old seen at a major hospital, with most being exclusively breastfed and some born prematurely
- Key finding: All six babies showed the same distinctive skin rash pattern and improved rapidly when given zinc supplements; breastfed babies developed symptoms earlier (around 3-5 months) because breast milk loses zinc after the first two months
- What it means for you: If your exclusively breastfed baby develops a persistent rash around the mouth and diaper area along with diarrhea and frequent infections, ask your doctor about zinc deficiency. This condition is rare but treatable, and early diagnosis prevents serious complications.
The Research Details
This study examined six babies treated at a major hospital who developed acrodermatitis enteropathica, a rare zinc deficiency condition. The researchers reviewed each baby’s medical history, symptoms, test results, and response to treatment. They looked for common patterns, such as whether the babies were breastfed, born early, or had genetic causes. The doctors documented the specific skin rashes and other symptoms each baby experienced and tracked how quickly they improved after starting zinc supplements.
By studying multiple cases together, doctors can identify patterns that help them recognize this rare condition faster. Early diagnosis is crucial because zinc deficiency can cause serious infections and slow growth in babies. Understanding which babies are at higher risk—like those who are exclusively breastfed or born prematurely—helps doctors watch for warning signs.
This is a case series, which means it describes real patients treated at one hospital rather than comparing groups in a controlled experiment. While this type of study is less powerful than larger trials, it’s valuable for rare conditions because they don’t happen often enough for big studies. The findings are based on actual patient outcomes, which makes them reliable for recognizing the condition, though the small number of cases means results may not apply to every situation.
What the Results Show
All six babies presented with the same distinctive pattern: a well-defined, crusty red rash around the mouth and in the diaper area. Every baby also experienced persistent diarrhea and erosive skin damage in sensitive areas. The average age when symptoms appeared was 8 months old, but breastfed babies showed symptoms much earlier, at an average of 3.25 months. Four of the six babies (66%) were exclusively breastfed, and three (50%) were born prematurely. These two factors appeared to increase the risk of developing this condition. Blood tests showed low zinc levels in four of the six babies (66%). One baby had a genetic test that confirmed a defect in the zinc transporter gene, which is the inherited form of this condition.
Beyond the skin rashes, babies experienced recurrent infections and growth delays, which are typical complications of zinc deficiency. The timing of symptom appearance in breastfed babies was particularly revealing: symptoms appeared earliest in babies who were exclusively breastfed, suggesting that breast milk’s changing zinc content plays a critical role. Researchers noted that breast milk contains the most zinc during the first 1-2 months after birth, then the zinc content drops significantly, which matches when breastfed babies typically develop symptoms.
This case series confirms what previous research has shown about acrodermatitis enteropathica: it causes distinctive skin rashes, digestive problems, and infections due to zinc deficiency. The study adds new insight by highlighting that exclusively breastfed babies and premature babies face higher risk. The finding about breast milk’s declining zinc content helps explain why symptoms appear at predictable ages in breastfed infants, which aligns with nutritional science about breast milk composition.
This study only included six babies from one hospital, so the findings may not apply to all cases worldwide. The small number means we can’t be completely certain about how common this condition is or whether the risk factors apply equally to all populations. One baby had genetic testing, but the others didn’t, so we don’t know how many had the inherited form versus acquired form. The study doesn’t include a comparison group of healthy babies, so we can’t measure exactly how much higher the risk is for breastfed or premature babies. Additionally, the study was published recently, so long-term follow-up data on these babies isn’t available yet.
The Bottom Line
If your exclusively breastfed baby develops a persistent, distinctive rash around the mouth and diaper area along with diarrhea and frequent infections between 3-6 months of age, consult your pediatrician about zinc deficiency testing. Zinc supplementation is safe and highly effective for treating this condition. For premature babies or those exclusively breastfed beyond 2-3 months, discuss zinc intake with your doctor. This research suggests zinc supplementation may be beneficial, though individual recommendations should come from your healthcare provider.
Parents of exclusively breastfed babies, especially those born prematurely, should be aware of these warning signs. Pediatricians and dermatologists should consider zinc deficiency when they see babies with this specific rash pattern. Healthcare providers caring for premature infants should monitor zinc status more closely. This condition is rare, so most parents won’t encounter it, but awareness helps ensure rapid diagnosis when it does occur.
Babies in this study showed rapid improvement after starting zinc supplements, with clinical improvement visible within days to weeks. However, complete healing of skin damage may take several weeks. Growth catch-up and immune function improvement typically occur over weeks to months of consistent supplementation. Long-term outcomes depend on maintaining adequate zinc intake and addressing the underlying cause (whether genetic or nutritional).
Want to Apply This Research?
- For parents of exclusively breastfed babies, track the appearance of any rashes (location, appearance, duration) and digestive symptoms (diarrhea frequency, consistency) weekly. Note the baby’s age and any infections. This creates a timeline that helps doctors identify patterns quickly if zinc deficiency is suspected.
- If your baby is exclusively breastfed beyond 2-3 months, discuss with your pediatrician about introducing zinc-rich foods (when age-appropriate) or zinc supplementation. Set reminders to discuss zinc status at regular pediatric checkups, especially for premature babies or those with digestive issues.
- Create a symptom log tracking skin condition, infection frequency, and growth milestones. If zinc supplementation is started, monitor for improvement in rash appearance and diarrhea over 1-2 weeks. Continue regular pediatric visits to confirm zinc levels are adequate and adjust supplementation as the baby grows and dietary intake changes.
This research describes a rare medical condition requiring professional diagnosis and treatment. The information provided is educational and should not replace consultation with a qualified pediatrician or dermatologist. If your baby shows symptoms of a persistent rash, diarrhea, or recurrent infections, seek immediate medical evaluation. Zinc supplementation should only be given under medical supervision, as improper dosing can cause harm. This case series involves only six patients and may not represent all cases of this condition. Individual medical decisions should be made in consultation with your healthcare provider who can evaluate your baby’s specific situation.