The role of bovine colostrum on recovery time and length of hospital stay of acute diarrhea in infants and children: a double-blind randomized controlled trial
Keywords:
Acute diarrhea, bovine colostrum, immune and growth factors, recovery time, length of hospital stay
Abstract
Background WHO standard treatment for acute diarrhea remainsunsatisfying to the parents of acute diarrhea patients, particularly
the need of medical treatment. Bovine colostrum contains immune
and growth factors that is thought able to neutralize some agents
causing acute diarrhea in infants and children.
Objective To evaluate the efficacy of bovine colostrum as adju-
vant therapy on recovery time and length of hospital stay for acute
diarrhea in infants and children.
Methods A double-blind randomized controlled trial was conducted
on infants and children with acute diarrhea admitted to Sanglah
Hospital. Treatment group received standard therapy with bovine
colostrums and control group received standard therapy plus pla-
cebo. The primary outcomes were achievement of recovery time
and length of hospital stay. Recovery time was determined by the
number of days needed to achieve defecation frequency <3 times/
day and needed to achieve normal stool consistency.
Results Seventy infants and children were enrolled. The treatment
group significantly achieved recovery time earlier than the control group
in regard to the time of achieving defecation frequency to <3 times/
day [2.31 (0.76) vs 3.34 (1.45); mean difference of -1.03; P= 0.001; CI
95% -1.58;-0.48] and normal stool consistency [2.40 (0.77) vs 3.43
(1.48); mean difference of -1.03; P = 0.001; CI 95% -1.59;-0.46]. Length
of hospital stay was shorter in the treatment group than the control
group [2.89 (0.78) vs 3.94 (1.53); mean difference of -1.05; P= 0.001;
CI 95% (-1.3;-0.7)]. No significant difference was found in mean of
body weight recovery in two groups [0.47 (0.16) vs 0.49 (0.20); mean
difference of -0.03; P=0.556; CI 95%: -0.11;0.06]. Age, nutritional
status, breastfeeding, and diarrhea before admission did not influ-
ence the study outcome.
Conclusion Bovine colostrums as an adjuvant in standard therapy
for acute diarrhea in infants and children is effective in regard to
achieve earlier recovery time and shorter length of hospital stay
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HB, editors. Nelson textbook of pediatrics. 16th ed.
Philadelphia: WB Saunders, 2000. p. 218-9.
2. Kandun I Nyoman. Upaya pencegahan diare ditinjau
dari aspek kesehatan masyarakat. Proceedings of
Kongres Nasional II Badan Koordinasi Gastroenterologi
Anak; 2003 July 3-5; Bandung, Indonesia.
3. Rahardjo E. Rotavirus penyebab utama diare (akut
gastroenteritis) pada anak-anak umur di bawah 2 tahun
(Baduta). Medika 1990;16:257-60.
4. Playford RJ, Macdonald CE, Johnson WS. Colostrum
and milk-derived peptide growth factors for the treat-
ment of gastrointestinal disorders. Clin Nutr 2000;
72:5-14.
5. Soetjiningsih. Peran air susu ibu dalam pencegahan dan
penatalaksanaan diare akut. In: Soetjiningsih, editor.
ASI petunjuk untuk tenaga kesehatan. 1st ed. Jakarta:
EGC, 1997. p. 64-75.
6. Noerasid H, Suraatmaja S, Asnil PO. Gastroenteritis
(diare) akut. In: Suharyono, Boediarso A, Halimun,
editors. Gastroenterologi anak praktis. 2nd ed. Jakarta:
BP FKUI, 1994. p. 51-76.
7. Diare akut. Pedoman diagnosis dan terapi Bagian/SMF
Ilmu Kesehatan Anak FK UNUD/RS Sanglah
Denpasar, 2000. p. 26-32.
8. Ylitalo S, Uhari M, Rasi S, Pudas J, Lepaluoto J.
Rotaviral antibodies in the treatment of acute rotaviral
gastroenteritis. Acta Paediatr 1998;87:264-7.
9. Sarker SA, Casswall TH, Mahalanabis D, Alam NH,
Albert MJ, Brussow H, et al. Successful treatment of
rotavirus diarrhea in children with immunoglobulin
from immunized bovine colostrums. Pediatr Infect Dis
J 1998;17:1149-54.
10. Pacyna J, Siwek K, Terry SJ, Roberton ES, Johnson RB,
Davidson GP. Survival of antibody activity derived from
bovine colostrum after passage through the human
gastrointestinal tract. J Pediatr Gastroenterol Nutr
2001;32:162-7.
11. Departemen Kesehatan RI. Epidemiologi dan
etiologi diare. In: Buku ajar diare. Jakarta:
Departemen Kesehatan RI, Direktorat Jendral
Pemberantasan Penyakit Menular dan Penyehatan
Lingkungan Pemukiman (Ditjen P2M & PLP),
1995. p. 3-136.
12. Mitra AK, Mahalanabis D, Ashraf H, Unicomb L, Eeckels
R, Tzipori S. Hyperimmune cow colostrum reduces diar-
rhea due to rotavirus: A double-blind randomized con-
trolled trial. Acta Pediatr 1995;84:996-1001.
13. Guarino A, Canani RB, Russo S, Albano F, Canani
MB, Ruggeri FM, et al. Oral immunoglobulins for treat-
ment of acute rotavirus gastroenteritis. Pediatrics
1994;93:12-6.
14. Mietens C, Keinhorst H, Hilpert H, Gerber H, Amster
H, Pahud JJ. Treatment of infantile E. coli gastroen-
teritis with spesific bovine anti E. coli milk immuno-
globulins. Eur J Pediatr 1979;132:239-52.
15. Huppertz HI, Rutkowski S, Busch DH, Eisebit R, Lissner
R, Karch H. Bovine colostrums ameliorates diarrhea in
infection with diarrhoeagenic E. coli, shiga toxin-pro-
ducing E. coli, and E. coli expressing intimin and hemol-
ysin. J Pediatr Gastroenterol Nutr 1999;29:452-56.
16. Sherman PM, Lichtman SN. Mucosal barrier function
and colonization of the gut. In: Walker WA, Durie PR,
Halminton JR, Walker-Smith JA, Watkins JB, editors.
Pediatric gastrointestinal disease. 2nd ed. St. Louis:
Mosby, 1996. p. 103-14.
17. Quigley JD, Martin KR, Dowlen HH. Concentration
of trypsin inhibitor and immunoglobulins in colostrum
of Jersey cows. J Dairy Sci 1995;78:1573-7.
18. Yolken RH, Losonsky GA, Vonderfecht S, Leister F,
Wee SB. Antibody to human rotavirus in cow’s milk.
N Engl J Med 1985;312:605-10.
19. Nataro JP, Kaper JB. Diarrhea-genic Escherichia coli.
Clin Microbiol Rev 1998;11:142-201.
20. Santoso H. Sistem pertahanan di dalam saluran cerna.
Presented at Pendidikan Kedokteran Berkelanjutan IV
Ilmu Kesehatan Anak FK UNUD, Denpasar; 2000
November.
Published
2016-10-18
How to Cite
1.
Suwarba I, S S, S H, Suandi I, Widiana R. The role of bovine colostrum on recovery time and length of hospital stay of acute diarrhea in infants and children: a double-blind randomized controlled trial. PI [Internet]. 18Oct.2016 [cited 22Nov.2024];46(3):127-3. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/915
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Received 2016-10-14
Accepted 2016-10-14
Published 2016-10-18
Accepted 2016-10-14
Published 2016-10-18
