Milk formulas in acute gastroenteritis and malnutrition: A randomized trial
Article first published online: 13 NOV 2002
Journal of Paediatrics and Child Health
Volume 38, Issue 6, pages 571–577, December 2002
How to Cite
Kukuruzovic, R. and Brewster, D. (2002), Milk formulas in acute gastroenteritis and malnutrition: A randomized trial. Journal of Paediatrics and Child Health, 38: 571–577. doi: 10.1046/j.1440-1754.2002.00044.x
- Issue published online: 13 NOV 2002
- Article first published online: 13 NOV 2002
- Accepted for publication 14 February 2002.
- Australian Aborigines;
- intestinal absorption;
- randomized clinical trial
Objective: To compare three low-lactose milk formulas differing in osmolality and degree of protein hydrolysis in the treatment of diarrhoea and malnutrition in subjects with high rates of lactose intolerance, osmotic diarrhoea and a tropical/environmental enteropathy.
Methods: A randomized double-blind trial of 180 Aboriginal children under 3 years of age admitted with acute diarrhoea and/or malnutrition was carried out. The intervention milk formulas were: (i) De-Lact, a low-osmolality lactose-free formula; (ii) O-Lac, a lactose-free formula; and (iii) Alfaré, a partially hydrolysed formula. Outcome measures were diarrhoeal severity, weight gain, formula palatability and changes in intestinal permeability (L/R ratios).
Results: The duration of diarrhoea in days (mean; 95% confidence interval) was significantly longer on Alfaré (8.5; 7.0−10.0) compared to De-Lact (6.1; 5.0−7.2) and O-Lac (6.9; 5.6−8.1; P = 0.04). There were no differences in mean intake between formulas, but palatability of Alfaré was significantly worse (P < 0.01) than the other formulas. Over the trial 5 days, improvement in L/R ratios was significantly greater (P = 0.05) for De-Lact (18.6; 10.6−26.6) than for Alfaré (8.5; 2.1−14.9). Weight gain was not significantly different between the three formulas, except in a malnourished subgroup who had better weight gain on De-Lact (P = 0.05).
Conclusions: In these Aboriginal children with diarrhoea and growth failure, a low osmolality milk was associated with better outcomes and a partially hydrolysed formula with less improvement in mucosal recovery, suggesting that cow's milk protein intolerance is not contributing to greater diarrhoeal severity or enteropathy in Aboriginal children.