The use of two Comfort YCFs in the dietary management of toddlers with a history of functional constipation: a randomized controlled trial

Abstract

Background: Pharmacological intervention with laxatives is the conventional treatment for functional constipation. Data to support the dietary management of functional constipation is lacking. This study compared the efficacy of two Comfort young child formulas with regards to the maintenance of healthy stooling parameters in toddlers with a history of constipation. It was registered in the Netherlands Trial Registry [identifier: NL7420 (NTR7653)], registration date 20/09/2018. Methods: Ninety-five healthy toddlers, aged 12 to 32 months, diagnosed with functional constipation (Rome III criteria) were randomized to receive one of two study formulas after pharmacological treatment. For the first month of the intervention, subjects received a laxative in a decreasing maintenance dose alongside a test or control formula (maintenance phase). Subsequently, subjects only consumed formula for another month (post-maintenance phase). Stooling parameters were obtained weekly using the Bristol Stool Scale and modified Rome III Questionnaire on Paediatric Gastrointestinal Symptoms for infants and toddlers. Differences in percentages of hard stools (primary outcome) and other stooling parameters were analysed using analysis of covariance and Chi-Square methods. Results: The overall percentage of hard stools was 5.02% in the test and 2.98% in the control group (n.s.). In the test group, these percentages dropped from 7.11% at the end of the maintenance phase, to 3.92% at the end of the post-maintenance phase (n.s.). In contrast, the % of hard stools in the control group was similar at the end of the maintenance (3.11%) and post-maintenance phase (2.77%; n.s.). No difference was found in the overall stool frequency between groups.At the end of the maintenance phase, only 22% and 19% of toddlers consuming the test and control formulae, respectively, met 2 or more of the criteria for functional constipation. At the end of the study, this percentage decreased to 9% in the test group (p=0.057), whereas it remained similar in the control group (21%, p=0.1). The number needed to treat for functional constipation was 8.3 in favour of the test formula at the end of the study period. No laxative use was reported in either study group during the post-maintenance phase. Conclusion: Both Comfort YCF support the maintenance of improved stooling over time in toddlers with a history of constipation. Children receiving the formula with intact protein tended to meet lower numbers of indicators of FC at the end of the study.