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A 2-month-old infant, who has been exclusively fed with cow's milk based formula develops a full body rash. Which of the following would be the most appropriate next step?

1: Switch to a soy protein based formula
2: Switch to a high MCT oil formula
3: Switch to a protein hydrolysate based formula
4: Switch to a lactose free cow's milk based formula

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Final answer:

For an infant with a rash potentially due to cow's milk based formula, the most appropriate step is to switch to a protein hydrolysate based formula which has proteins broken down into smaller parts to reduce the likelihood of an allergic reaction.

Step-by-step explanation:

The most appropriate next step for a 2-month-old infant who develops a full body rash after being exclusively fed with cow's milk based formula would likely be to switch to a protein hydrolysate based formula. Cow's milk proteins can be difficult for an infant to digest and can lead to allergic reactions, which might present as a rash. A protein hydrolysate formula contains proteins that are broken down into smaller peptides, making them easier to digest and less likely to trigger an allergic reaction.

In contrast, switching to a soy protein-based formula might not be the best initial move, as some infants who are allergic to cow's milk protein could also react to soy protein. A formula with high MCT (medium-chain triglycerides) oil is often used for malabsorption issues, but does not address potential allergic responses to protein. Lastly, a lactose-free cow's milk-based formula would not be suitable if the issue is a protein allergy rather than lactose intolerance.

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