Nutritional intervention in acute diarrhea: is a lactose-free formula essential?
A prospective study was done to determine the incidence of disaccharide intolerance among 3-36 month-old patients with acute watery diarrhea who were on breast feeding and/or lactose-containing formula. The effect of feeding intervention on the outcome was investigated. Significant disaccharide intolerance was defined as one with (1) biochemical derangements: stool pH < 6.0 (Riedel de Haen pH paper) and reducing substances > or = 0.5 mg% (Clinitest) on two consecutive determinations and (2) clinical evidence: high purging rate (> 10 gm/kg/hour) and reappearance of dehydration and/or weight loss while on a lactose containing milk. Seven of 92 patients (7.8%) had biochemical evidence of disaccharide malabsorption on admission. Subsequent monitoring of the study population showed absence of disaccharide intolerance. Despite a lactose containing formula, a significant (p < 0.05) reduction in stool output from the first to the second day (145.85 +/- 130.26 vs 115.43 +/- 95.65 g/kg admission weight) was noted. Likewise, weight gain from admission to discharge (4.56 +/- 3.44%) was observed. The mean total duration of illness (4.75 +/- 2.84 days) was well within the usual course of five to seven days. This study supports the current recommendation of continued breast feeding and/or use of lactose containing formula during acute watery diarrhea.
Gregorio
G V
GV
Department of Pediatrics, University of the Philippines, Philippine General Hospital, Ermita, Manila.
Rogacion
J M
JM
Gabriel
E P
EP
Santos Ocampo
P D
PD
D000208:Acute Disease; D001942:Breast Feeding; D002675:Child, Preschool; D003967:Diarrhea / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007225:Infant Food; D007787:Lactose Intolerance / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D015430:Weight Gain / Q000502:physiology