Milk formulas in acute gastroenteritis and malnutrition: A randomized trial

Kukuruzovic, Renata H; Brewster, David

doi:10.1046/j.1440-1754.2002.00044.x

Cited by 29 publications

(33 citation statements)

References 27 publications

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“…In Australian Aboriginal children who were underweight, osmotic diarrhoea was a common complication and linked to lactose intolerance and increased intestinal permeability leading to severe purging, hypokalaemia and metabolic acidosis [24]. In these children a low osmolarity, low lactose milk formula resulted in significantly better weight gain than either a low lactose or partially hydrolysed milk formula (both having higher osmolarities) [25]. A Zambian controlled trial of 4 weeks’ feeding with an amino acid-based elemental feed in severely malnourished or underweight children with persistent diarrhoea found better weight gains and greater increases in haemoglobin level than in children fed on cow’s milk or soya based formulas [26].…”

Section: Discussionmentioning

confidence: 99%

Diarrhoea Complicating Severe Acute Malnutrition in Kenyan Children: A Prospective Descriptive Study of Risk Factors and Outcome

et al. 2012

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BackgroundSevere acute malnutrition (SAM) accounts for two million deaths worldwide annually. In those hospitalised with SAM, concomitant infections and diarrhoea are frequent complications resulting in adverse outcome. We examined the clinical and laboratory features on admission and outcome of children with SAM and diarrhoea at a Kenyan district hospital.MethodsA 4-year prospective descriptive study involving 1,206 children aged 6 months to 12 years, hospitalized with SAM and managed in accordance with WHO guidelines. Data on clinical features, haematological, biochemical and microbiological findings for children with diarrhoea (≥3 watery stools/day) were systematically collected and analyzed to identify risk factors associated with poor outcome.ResultsAt admission 592 children (49%) had diarrhoea of which 122 (21%) died compared to 72/614 (12%) deaths in those without diarrhoea at admission (Χ2 = 17.6 p<0.001). A further 187 (16%) children developed diarrhoea after 48 hours of admission and 33 died (18%). Any diarrhoea during admission resulted in a significantly higher mortality 161/852 (19%) than those uncomplicated by diarrhoea 33/351 (9%) (Χ2 = 16.6 p<0.001). Features associated with a fatal outcome in children presenting with diarrhoea included bacteraemia, hyponatraemia, low mid-upper arm circumference <10 cm, hypoxia, hypokalaemia and oedema. Bacteraemia had the highest risk of death (adjusted OR 6.1; 95% C.I 2.3, 16.3 p<0.001); and complicated 24 (20%) of fatalities. Positive HIV antibody status was more frequent in cases with diarrhoea at admission (23%) than those without (15%, Χ2 = 12.0 p = 0.001) but did not increase the risk of death in diarrhoea cases.ConclusionChildren with SAM complicated by diarrhoea had a higher risk of death than those who did not have diarrhoea during their hospital stay. Further operational and clinical research is needed to reduce mortality in children with SAM in the given setting.

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Section: Discussionmentioning

confidence: 99%

Diarrhoea Complicating Severe Acute Malnutrition in Kenyan Children: A Prospective Descriptive Study of Risk Factors and Outcome

et al. 2012

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“…This could be indicative of an osmotic effect. Some studies have documented an increase in stool output/diarrhoea and a reduction in absorption of macronutrients in infants on feeds with a higher osmolality (Lifschitz & Carrazza, 1990; Kukuruzovic & Brewster, 2002) given at FS on day one. In contrast, another study (Khoshoo & Brown, 2002) investigating the gastric emptying of high‐ and low‐energy density whey‐based formulas in children with poor weight gain due to volume intolerance, found that an equal volume of the high‐energy density formula produced better weight gain without a change in tolerance.…”

Section: Discussionmentioning

confidence: 99%

Should high‐energy infant formula be given at full strength from its first day of usage?

Evans

Twaissi

Daly

et al. 2006

J Human Nutrition Diet

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“…[58][59][60][61] Lactose-Free Formulas In developed countries, even in the case of acute gastroenteritis, enough lactose digestion and absorption are preserved so that low-lactose and lactose-free formulas have no clinical advantages compared with standard lactose-containing formulas except in severely undernourished children, in whom lactose-containing formu-las may worsen the diarrhea and lactose-free formulas may be advantageous. 62 Breastfed infants should be continued on human milk in all cases. 57 This has also been reviewed recently in the American Academy of Pediatrics' practice guideline for acute gastroenteritis.…”

Section: Managementmentioning

confidence: 99%

Lactose Intolerance in Infants, Children, and Adolescents

Heyman¹

2006

Pediatrics

456

348

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The American Academy of Pediatrics Committee on Nutrition presents an updated review of lactose intolerance in infants, children, and adolescents. Differences between primary, secondary, congenital, and developmental lactase deficiency that may result in lactose intolerance are discussed. Children with suspected lactose intolerance can be assessed clinically by dietary lactose elimination or by tests including noninvasive hydrogen breath testing or invasive intestinal biopsy determination of lactase (and other disaccharidase) concentrations. Treatment consists of use of lactase-treated dairy products or oral lactase supplementation, limitation of lactose-containing foods, or dairy elimination. The American Academy of Pediatrics supports use of dairy foods as an important source of calcium for bone mineral health and of other nutrients that facilitate growth in children and adolescents. If dairy products are eliminated, other dietary sources of calcium or calcium supplements need to be provided. INTRODUCTIONSIGNIFICANT CHANGES IN our knowledge and approach toward lactose intolerance have occurred over the past quarter century, since the first statement on lactose intolerance was published by the American Academy of Pediatrics Committee on Nutrition. 1 Lactose ingestion in certain susceptible individuals can cause abdominal symptoms that are variable and can be treated with dietary restriction or enzyme replacement, depending on the amount of lactose consumed and the degree of lactase deficiency. Pediatricians and other pediatric care providers should maintain awareness of the benefits and controversies related to the consumption of dietary milk products and milk-based infant formula. The lactose content of milk often influences, correctly or not, the ultimate decision about the use or continuation of milk in the diet. Milk and dairy-product avoidance has a negative effect on calcium and vitamin D intake in infants, children, and adolescents. Other nutrients such as protein make dairy products an important source of nutrition for growing children. This revised statement will update the initial statement of 1978 while incorporating changes from the 1990 supplement 2 and current state-of-theart relating to lactose intolerance. Recommendations regarding dietary calcium have been updated recently. 3 Lactose, a disaccharide that comprises the monosaccharides glucose and galactose, is the primary carbohydrate found exclusively in mammalian milk. Absorption of lactose requires lactase activity in the small intestinal brush border to split the bond linking the 2 monosaccharides. A ␤-galactosidase termed "lactase-phlorizin hydrolase" (lactase) accounts for most of the lactase activity in the intestinal

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Milk formulas in acute gastroenteritis and malnutrition: A randomized trial

Cited by 29 publications

References 27 publications

Diarrhoea Complicating Severe Acute Malnutrition in Kenyan Children: A Prospective Descriptive Study of Risk Factors and Outcome

Diarrhoea Complicating Severe Acute Malnutrition in Kenyan Children: A Prospective Descriptive Study of Risk Factors and Outcome

Should high‐energy infant formula be given at full strength from its first day of usage?

Lactose Intolerance in Infants, Children, and Adolescents

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