Continued normal feeding and clear fluids only followed by gradual milk strength reintroduction or immediate full strength produced no significant differences in outcome and symptoms
Is it necessary to regraduate milk after acute gastroenetritis
in children?
Haque KN et al
Tropical and Geographical Medicine 1983; 35:369-73
Three-part Clinical Question
In children with gstro-enteritis is
gradual introduction of feeding better than immediate normal feeding with
regards to symptom control and time to resolution?
Search Terms
Medline 1966- 09/01 using OVID interface( exp
Gastro-enteritis) AND ( exp bottle feeding OR exp breast feeding methods OR
"feeding".mp) LIMIT to human AND ( newborn infant OR infant OR
preschool child OR child ).
The Study
Non-blinded randomised controlled trial with intention-to-treat.
The Study Patients
150 inpatients (76 males, 74 females), acute
gastro-entritis at all stages of dehydration between 1 month and 2 years of
age, 14.6% breast fed, 25.3% bottle-fed, 59.3% mixed
Control group
(N = 52; 52 analysed): clear fluids (6 to 24 hrs) then
gradual 1/4 strength milk reintroduction
Experimental group
(N = 46/52; 46/52 analysed): one group clear fluids
(6-24 hrs) then full strength milk, the other group continuing full strength
milk
The Evidence
Non-Event Outcomes |
Regraded group |
Clear-Full group |
Full Group |
P-value |
Increase in weight at discharge(kg) |
0.4(0.1) |
0.8(0.2) |
1.2(0.7) |
NS |
Diarrhoea length (days) |
3.0(1.4) |
3.0(1.3) |
3.8(1.2) |
NS |
Vomiting Length (days) |
1.0(1.1) |
1.8(1.3) |
1.6(1.2) |
NS |
Length in hospital (days) |
3.1(1.4) |
3.6(1.2) |
3.8(1.2) |
NS |
Comments
Large proportion of patients malnourished
Appraised by
Nico Grunenberg, Ravenswood Surgery, New Road, Forfar, DD8
2AE; 28 November 2002
Email: peni.grunenberg@virgin.net