The Effect of Feeding Four Different Formulae on Stool Weights in Prolonged Dehydrating Infantile Gastroenteritis

R, Rajah; Pettifor, John M.; Noormohamed, Madni; Venter, André; Rosen, Eric; Rabinowitz, Leslie; Stein, Harry

doi:10.1097/00005176-198803000-00008

Cited by 26 publications

(14 citation statements)

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“…Six studies compared cow’s milk or cow’s milk-based formula with soy-based, casein-based or whey-based formulas [16,23,31-34], one study compared regular milk to milk in which at least 95% of the lactose had been hydrolyzed [35], and one study compared soy-based formulas with and without added lactose [36]. Three studies allowed non-milk complementary foods in addition to the intervention and control liquid feeds, with complementary foods given identically across comparison groups [16,32,36].…”

Section: Resultsmentioning

confidence: 99%

“…Effect sizes and their statistical significance varied across studies but were consistent in direction (Figure 2). No effect of lactose-free liquid feeds was shown in the pooled results from three studies on stool output [16,34,35] or from three studies on weight change [16,35,36], but the evidence from seven studies [16,23,32-36] showed a statistically significant reduction of 47% in the risk of treatment failure (RR: 0.53; 95%CI: 0.40 to 0.70; p<0.0001). Effect sizes and their statistical significance varied across studies but were consistent in direction with the exception of one study (Figure 3).…”

Section: Resultsmentioning

confidence: 99%

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Dietary management of childhood diarrhea in low- and middle-income countries: a systematic review

et al. 2013

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BackgroundCurrent WHO guidelines on the management and treatment of diarrhea in children strongly recommend continued feeding alongside the administration of oral rehydration solution and zinc therapy, but there remains some debate regarding the optimal diet or dietary ingredients for feeding children with diarrhea.MethodsWe conducted a systematic search for all published randomized controlled trials evaluating food-based interventions among children under five years old with diarrhea in low- and middle-income countries. We classified 29 eligible studies into one or more comparisons: reduced versus regular lactose liquid feeds, lactose-free versus lactose-containing liquid feeds, lactose-free liquid feeds versus lactose-containing mixed diets, and commercial/specialized ingredients versus home-available ingredients. We used all available outcome data to conduct random-effects meta-analyses to estimate the average effect of each intervention on diarrhea duration, stool output, weight gain and treatment failure risk for studies on acute and persistent diarrhea separately.ResultsEvidence of low-to-moderate quality suggests that among children with acute diarrhea, diluting or fermenting lactose-containing liquid feeds does not affect any outcome when compared with an ordinary lactose-containing liquid feeds. In contrast, moderate quality evidence suggests that lactose-free liquid feeds reduce duration and the risk of treatment failure compared to lactose-containing liquid feeds in acute diarrhea. Only limited evidence of low quality was available to assess either of these two approaches in persistent diarrhea, or to assess lactose-free liquid feeds compared to lactose-containing mixed diets in either acute or persistent diarrhea. For commercially prepared or specialized ingredients compared to home-available ingredients, we found low-to-moderate quality evidence of no effect on any outcome in either acute or persistent diarrhea, though when we restricted these analyses to studies where both intervention and control diets were lactose-free, weight gain in children with acute diarrhea was shown to be greater among those fed with a home-available diet.ConclusionsAmong children in low- and middle-income countries, where the dual burden of diarrhea and malnutrition is greatest and where access to proprietary formulas and specialized ingredients is limited, the use of locally available age-appropriate foods should be promoted for the majority of acute diarrhea cases. Lactose intolerance is an important complication in some cases, but even among those children for whom lactose avoidance may be necessary, nutritionally complete diets comprised of locally available ingredients can be used at least as effectively as commercial preparations or specialized ingredients. These same conclusions may also apply to the dietary management of children with persistent diarrhea, but the evidence remains limited.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Dietary management of childhood diarrhea in low- and middle-income countries: a systematic review

et al. 2013

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“…Significant risk factors for failure and delayed recovery included younger age and vomiting during the first 8 h after admission. These factors have also been associated with increased failure rates in studies from Africa (9) and Brazil (22). Additional factors which predicted delayed recovery included greater degree of malnutrition, fever and passage of watery stools, greater stool frequency and volume and greater ORS intake during the observation period.…”

Section: Discussionmentioning

confidence: 99%

“…As of yet, no other data on risk factors associated with nutritional therapy using culturally acceptable diets are available. However, earlier studies of nutritional therapy for diarrhea have also indicated that malnutrition, fever, and initial severity of stooling may be linked to poorer outcome (9,(22)(23)(24)(25)(26)(27)(28)(29). If these findings are substantiated by other studies, a clinical assessment profile may be developed which could help guide health care workers to identify children who require more supervised therapy or hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Nutritional management of persistent diarrhea: factors predicting clinical outcome

et al. 1992

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In a prospective study we randomized 102 male children (age 6‐36 months) with persistent diarrhea to receive a traditional rice‐lentil (Khitchri) diet and yogurt (K‐Y) or a soy formula (alone for seven days and then in combination with K‐Y for seven days). Of 73 children satisfying the study criteria, 66 were successfully treated and there were 7 treatment failures. There was poor concordance between parental accounts of severity of diarrhea or vomiting and that observed after admission. Significant risk factors associated with treatment failure included younger age (p<0.005) and vomiting at presentation (p<0.02). The greatest number of risk factors associated with delayed recovery (<10 days) were identified during an initial evaluation period (the first 8 h after admission). These included greater severity of watery diarrhoea (p<0.01) and increased ORS intake (p<0.02). Our data suggest that an initial evaluation period, including objective observations, may identify children with persistent diarrhea who are at greatest need of hospitalization.

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“…O diagnósti-co presuntivo de alergia alimentar se faz com provas de supressão e provocação com as proteínas em questão, em especial à proteína do leite de vaca 17 61 . Apesar do consenso de que a proteína da soja pode ser causa de alergia alimentar 62 , alguns estudos têm mostrado bons resultados com o uso de fórmulas de soja no tratamento dessa patologia 63,64 . Outros autores publicaram estudos relatando bons resultados com o uso da fórmula de frango no tratamento de crianças com diarréia prolongada 65,66 .…”

Section: Manejo Terapêuticounclassified

Persistent diarrhea

Andrade¹,

Moreira²,

Neto³

2000

J Pediatr (Rio J)

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The Effect of Feeding Four Different Formulae on Stool Weights in Prolonged Dehydrating Infantile Gastroenteritis

Cited by 26 publications

References 0 publications

Dietary management of childhood diarrhea in low- and middle-income countries: a systematic review

Dietary management of childhood diarrhea in low- and middle-income countries: a systematic review

Nutritional management of persistent diarrhea: factors predicting clinical outcome

Persistent diarrhea

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