Randomised trial of different rates of feeding in acute diarrhoea

Abstract

Objective-To compare the eVect of different feeding frequencies on the speed of recovery from diarrhoea. Methods-A randomised, non-blinded trial provided 0.452 MJ/kg/day as either 6 or 12 feeds of cows' milk each day to 262 hospitalised male infants aged 3-12 months with acute diarrhoea. Stool frequency, stool weight, body weight, and diarrhoea complications were monitored until recovery or for 14 days. Results-A proportional hazards regression model controlling for age, diarrhoea aetiology, and severity of dehydration on admission revealed that the frequently fed group had a significantly shorter duration of diarrhoea (hazards ratio, 1.29; 95% confidence interval, 1.002 to 1.653). Frequently fed infants had a significantly greater weight gain and significantly lower faecal frequency and faecal weight. Conclusions-Breast feeding remains the preferred method of feeding infants with acute diarrhoea, but feeding cows' milk to adequately nourished infants with acute diarrhoea is safe and is more rapidly eVective if provided in frequent feeds with low energy loads. (Arch Dis Child 1999;81:487-491)

Diarréia Aguda em Sergipe: manejo pré-hospitalar e admissão na emergência

“…A reintrodução dos alimentos deve ser o mais precoce possível, assim que a fase de reidratação estiver completa (após fase rápida do plano C), a fim de reduzir a severidade, duração e conseqüências nutricionais da diarréia (Behrens, 1993;Gracey, 1999;Schroeder, 1997;Nanulescu et al, 1995). A maioria das crianças pode receber leite não diluído e o uso de fórmulas sem lactose (Chew et al, 1993;Wan et al, 1999;Guarino & Albano, 2001). O aleitamento materno nunca deve ser suspenso, pois, além de alimentar, tem propriedades antibacterianas e está isento do risco de alergia (Guarino & Albano, 2001).…”

Clinical and Bacteriological Study of Acute Diarrhoea in Children

“…The mean frequency of diarrhoea before admission in present study was 9.02 stools per day. However Chaomin Wan et al 1999 19 and Anthony et al reported a mean frequency of 15.166 and 13.09 +_ 0.94 stools per day respectively.…”

Approach to the Patient with Diarrhea

“…At one time, complete or partial bowel rest was recommended during acute diarrhea. It is clear that patients with acute diarrhea should be fed, not starved [133,134]. Continued breast-feeding or half-strength formula for infants is recommended.…”

“…Severe malnutrition and death (mortality up to 50%) can ensue [141]. Treatment includes dietary lactose exclusion in mild disease [142] and controlled feeding or total parenteral nutrition in those who are severely affected [134]. Metronidazole, tetracycline, trimethoprimsulfamethoxazole, folic acid, and zinc therapy may also be of help [141,144].…”