Cow's milk-based formula, human milk, and soya feeds in acute infantile diarrhea: a therapeutic trial

Abstract

Acute infantile diarrhea is often managed by introducing lactose-free diets empirically from the time of diagnosis, in addition to conventional rehydration therapy. In order to assess the efficacy of this, a therapeutic trial was undertaken in which hospitalized gastroenteritis patients previously on milk-formula feeds were randomly fed, from the time of admission, either their original feed or a lactose-free soya preparation; patients previously on human milk with or without a supplement continued to receive this during their diarrheal illness. The results show that in nonrotaviral gastroenteritis, there is no difference in the duration of the illness irrespective of the type of feed given. In rotaviral gastroenteritis, continued breast-feeding significantly reduces the duration of acute diarrhea, while lactose-free soya feeds do not lead to a significant reduction in the duration of the illness when compared to cow's milk-formula feeds. Hence, it is concluded that (a) breast-feeding should be continued during an episode of infantile diarrhea, and that (b) empirical use of soya preparations from the time of hospital admission is not justified; however, the latter should be considered in infants whose purging rate goes up or diarrheal disease severity worsens 3 to 4 days after the onset of diarrhea or hospital stay and who are passing significant amounts of reducing sugars in their stool.

PIP: Acute infantile diarrhea is often managed by introducing lactose-free diets empirically from the time of diagnosis, in addition to conventional rehydration therapy. In order to assess the efficacy of this, a therapeutic trial was undertaken in which hospitalized gastroenteritis patients previously on milk-formula feeds were randomly fed, from the time of admission, either their original feed or a lactose-free soya preparation. Patients who had previously had human milk with or without a supplement continued to receive this during their diarrheal illness. The results show that in nonrotaviral gastroenteritis, there is no difference in the duration of the illness, irrespective of the type of feed given. In rotaviral gastroenteritis, continued breastfeeding significantly reduces the duration of acute diarrhea, while lactose-free soya feeds do not lead to a significant reduction in the duration of the illness when compared to cow's milk- formula feeds. Therefore, the authors concluded that: breastfeeding should be continued during an episode of infantile diarrhea, and empirical use of soya preparations from the time of hospital admission is not justified. However, the latter should be considered in infants whose purging rate goes up or diarrheal disease severity worsens 3-4 days after diarrhea onset or hospital stay and who are passing significant amounts of reducing sugars in their stool.