Immediate full strength feeding was associated with recurrence of symptoms mainly in children below 9 months

Comparison of two feeding regimens following acute gastroenteritis in infancy
Placzek M, Walker-Smith JA
Journal of Paediatric Gastroenterology & Nutrition 1984; 3:245-8

Three-part Clinical Question
In children with gastro-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 Gastroenteritis) AND (exp bottle feeding OR exp breast feeding OR exp 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
48 inpatients, acute gastroenteritis, less than 18 months of age, gastroentritis only, not breast fed

Control group
(N = 25; 25 analysed): 24 hrs glucose-electrolyte mixture, gradual increase from 1/4 strength milk, increase 1/4 strength every 24 hrs

Experimental group
(N = 23; 23 analysed): 24 hrs glucose-electrolyte mixture, then full strength milk

The Evidence

Outcome	Time to Outcome	CER	EER	RRR	ARR	NNT
Complicated clinical course= recurrence of either severe vomiting or watery diarrhoea with 2% or more reducing substances		0.040	0.304	-660%	-0.264	-4
	95% Confidence Intervals:			-100% to -152%	-0.467 to -0.061	-17 to -3

Comments
Small numbers. Randomisation by alternate allocation

Appraised by
Nico Grunenberg, Ravenswood Surgery, New Road, Forfar, DD8 2AE; 28 November 2002
Email: peni.grunenberg@virgin.net