EFFICACY OF MILK-BASED DIETS IN PERSISTENT DIARRHEA - A RANDOMIZED, CONTROLLED TRIAL

Objective. Previous studies have shown increased stool output when chi ldren with persistent diarrhea (PD) received milk as the predominant s ource of nutrition. Methods. We evaluated the efficacy of milk given i n modest amounts as a part of a mixed diet in children with PD. One hu ndred sixteen children 3 to 24 months of age with diarrhea for between 14 days and 12 weeks were allocated to milli-based (n = 60) or milk-f ree (n = 56) cereal dietary regimens. The two diets were isocaloric (8 6.9 calories/100 g for less than or equal to 9 months; 95.6 cal/100 g for >9 months) consisting of puffed rice cereal, sugar, and oil differ ing in only their source of protein, which was either milk or egg whit e, respectively. An average of 30% of the calories were constituted by milk in the milk-cereal diet, Both diets were offered at the rate of 150 kcal/kg per day. Children receiving milk-cereal consumed an averag e of 1.9 g/kg lactose per day.Results. The baseline characteristics in the two groups were similar. Comparable amounts of diet were consumed in both groups. The milk-cereal group did not have higher median (ran ge) stool output (g/kg/h) compared with the milk-free group during a 0 - to 48-hour (milk-cereal, 1.7 [0.2 to 8.7]; milk-free, 1.5 [0.1 to 6. 6]) or 0- to 120-hour (milk-cereal, 1.6 [0.4 to 7.2]; milk-free, 1.3 [ 0.1 to 7.6]) period. The percentage of weight gain was similar in the two groups, and there were no significant differences in the duration of diarrhea. Overall, 23 children had treatment failures, 10 (17%) in the milk-cereal and 13 (23.6%) in the milk-free groups. Conclusions. O ur findings suggest that modest intakes of milk are well tolerated as a part of mixed diet during PD.