Effectiveness of lactose-free formula in management of acute rotavirus diarrhea
Keywords:
diarrheal rotavirus, baby formula, randomized controlled trial, double-blind study
Abstract
Background Acute rota virus diarrhea causes mucosal destruction, blunted villi, villus shortening, and death of cells. The process also decreases lactose secretion which responsible in lactose absorption. Non-absorbed lactose then causes the progression of osmotic and secretory diarrhea causing delayed recovery. Lactose-free formula may decrease lactose, thus shortened the duration of diarrhea episode.Objective To compare the cure rate and duration of acute rota virus diarrhea in children treated with lactose-free formula and lactose containing formula.
Methods A randomized, double-blind controlled trial was performed to infants and children aged 2: 6 to 59 months old with acute rotavirus diarrhea accompanied with mild or moderate dehydration that were admitted to pediatric gastroenterology division. Latex agglutination test was used to detect rota virus. After an appropriate rehydration therapy had been done, they were fed with either lactose-free formula (n = 29) or lactose-containing formula (n = 31). Comparisons between duration of diarrhea, weight gain, and defecation frequency were made. Statistical analysis for comparing the two groups were independent t-test and multivariate analysis (Cox regression). Statistical significant was defined ifF< 0.05 with 95% confidence interval.
Results The mean duration of diarrhea in lactose-free formula
group was 57.59 hours (SD 9.40) and lactose-containing formula
was 85.97 hours (SD 13.94), mean difference was 28.38 hours
(SE 3.09) [P = 0.001; (95% CI 22.19 to 34.56)]. Decrease in
stool frequency was found significantly in the lactose-free formula group. Multivariate analysis (Cox regression) revealed that the intervention was affected significantly.
Conclusion Lactose-free formula may shorten the duration of acute rotavirus diarrhea.
References
1. World Health Organization. World Health Report Geneva.
2002 [cited 2004 Sept 12]. Available from: http://whqlibdoc.
who.int/hq/2002/WHO_WHR_02.1.pdf.
2. Departemen Kesehatan Republik Indonesia. Profit kesehatan
Indonesia 2001 [cited 2004 Sept 12]. Available from: http//
www.depkes.go.id.
3. Bernstein DI, Ward RL. Rotavirus infection. Pediatr Rev.
2003;24:322-3.
4. Bresee J, Fang ZY, Wang B, Nelson EAS, Tam J, Soenarto
Y, et al. First report from the Asian rotavirus surveillance
network. Emerg Infect Dis. 2004; 10:988-95.
5. Soenarto SY, Aman TA, Bakri A, Waluya H, Firmansyah A,
Kadin M, et al. The burden of severe rotavirus diarrhea in
Indonesia. J Infectious Diseases. In Press 2008.
6. Murphy MS. Guidelines for managing acute gastroenteritis
based on systematic review of published research. Arch Dis
Child. 1998;7:279-84.
7. Simakachorn N, Tongpenyai Y, Tangtan 0, Varavithya
W Randomized double-blind clinical trial oflactosa-free
and lactose-containing formula in dietary management
of acute childhood diarrhea. J Med Assoc Thai.
2004;87:641-9.
8. Pudjiadi S. Ilmu gizi klinis pada anak. 4th ed. Jakarta: Balai
Penerbit Fakultas Kedokteran Universitas Indonesia, 2000;
p. 53-226.
9. Sack DA, Chowdhury AM, Eusof A, AliMA, Merson MH,
Islam S, et al. Oral hydration rotavirus diarrhoea: a double
blind comparison of sucrose with glucose electrolyte solution.
Lancet. 1978;2:280-3.
10. Lozano JM, Cespedes JA. Lactose vs. lactose free regimen in
children with acute diarrhoea: a randomized controlled trial.
Arch Latinoam Nutr. 1994;44:6-11.
11. Santosham M, Foster S, Reid R, Bertrando R, Yolken R,
Burns B, et al. Role of soy-based, lactose-free formula during
treatment of acute diarrhea. Pediatrics. 1985;76:292-8.
2002 [cited 2004 Sept 12]. Available from: http://whqlibdoc.
who.int/hq/2002/WHO_WHR_02.1.pdf.
2. Departemen Kesehatan Republik Indonesia. Profit kesehatan
Indonesia 2001 [cited 2004 Sept 12]. Available from: http//
www.depkes.go.id.
3. Bernstein DI, Ward RL. Rotavirus infection. Pediatr Rev.
2003;24:322-3.
4. Bresee J, Fang ZY, Wang B, Nelson EAS, Tam J, Soenarto
Y, et al. First report from the Asian rotavirus surveillance
network. Emerg Infect Dis. 2004; 10:988-95.
5. Soenarto SY, Aman TA, Bakri A, Waluya H, Firmansyah A,
Kadin M, et al. The burden of severe rotavirus diarrhea in
Indonesia. J Infectious Diseases. In Press 2008.
6. Murphy MS. Guidelines for managing acute gastroenteritis
based on systematic review of published research. Arch Dis
Child. 1998;7:279-84.
7. Simakachorn N, Tongpenyai Y, Tangtan 0, Varavithya
W Randomized double-blind clinical trial oflactosa-free
and lactose-containing formula in dietary management
of acute childhood diarrhea. J Med Assoc Thai.
2004;87:641-9.
8. Pudjiadi S. Ilmu gizi klinis pada anak. 4th ed. Jakarta: Balai
Penerbit Fakultas Kedokteran Universitas Indonesia, 2000;
p. 53-226.
9. Sack DA, Chowdhury AM, Eusof A, AliMA, Merson MH,
Islam S, et al. Oral hydration rotavirus diarrhoea: a double
blind comparison of sucrose with glucose electrolyte solution.
Lancet. 1978;2:280-3.
10. Lozano JM, Cespedes JA. Lactose vs. lactose free regimen in
children with acute diarrhoea: a randomized controlled trial.
Arch Latinoam Nutr. 1994;44:6-11.
11. Santosham M, Foster S, Reid R, Bertrando R, Yolken R,
Burns B, et al. Role of soy-based, lactose-free formula during
treatment of acute diarrhea. Pediatrics. 1985;76:292-8.
Published
2009-10-31
How to Cite
1.
Hartawan IN, Soenarto S, Suandi IKG. Effectiveness of lactose-free formula in management of acute rotavirus diarrhea. PI [Internet]. 31Oct.2009 [cited 24Nov.2024];49(5):299-03. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/587
Section
Articles
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Received 2016-09-11
Accepted 2016-09-11
Published 2009-10-31
Accepted 2016-09-11
Published 2009-10-31
