TY - JOUR T1 - The ‘Pink herring’ JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - 372 LP - 373 DO - 10.1136/archdischild-2018-316682 VL - 105 IS - 6 AU - Siew Cheng Foong AU - May Loong Tan AU - Wai Cheng Foong AU - Jacqueline Judith Ho Y1 - 2020/12/01 UR - http://ep.bmj.com/content/105/6/372.abstract N2 - A 3-month-old infant, exclusively fed with his mother’s expressed milk, was diagnosed with a parotid haemangioma and prescribed oral propranolol. Soon after starting propranolol, his clothes that were soiled by regurgitated milk (initially ‘milk-coloured’) mysteriously turned pink if left unwashed overnight. His mother initially thought it was because of the pink-coloured propranolol (figure 1). After 3.5 months, when the pink changes persisted despite stopping propranolol for a week, his mother brought him to our attention.Figure 1 Picture of propranolol and stained shirt.Physical examination of the 6.5-month-old infant revealed an involuted haemangioma. His weight and length (which was at the 15th centile from birth until 3 months of age) had dropped to the third centile. He was otherwise well and had normal development.Which of the following is a cause of the pink-coloured changes?Ingested blood from his mother’s breasts.Red dragon fruit his mother ate.Propranolol.Bleeding visceral haemangioma.Meckel’s diverticulum. … ER -