EFFECTS OF IMMEDIATE MODIFIED FEEDING ON INFANTILE GASTROENTERITIS

Background. Standard treatment of infants who are dehydrated as a resu lt of acute gastroenteritis is to administer oral rehydration therapy (ORT). Traditionally, food has been withdrawn for 24-48 h, but there i s no conclusive evidence that this is of any real benefit to the patie nt. Immediate modified feeding, in which an infant on ORT is not starv ed but administered a limited diet, may have benefits in the treatment of gastroenteritis, especially in children who are nutritionally comp romised before they develop the illness. Aim. A pilot study was carrie d out to investigate the effects of giving infants suffering from acut e gastroenteritis a limited modified diet in conjunction with ORT. Met hod. Infants recruited into the study by their general practitioner or by a research doctor in the hospital casualty unit of Bristol Childre n's Hospital were randomly allocated to receive ORT with or without im mediate modified feeding. The duration of diarrhoea, weight change, an d incidence of vomiting and lactose intolerance were measured in both treatment groups, and the results were compared. Results. Of the infan ts studied, 27 received ORT and immediate modified feeding, and 32 ORT alone. The duration of diarrhoea, and incidence of vomiting or lactos e intolerance were no greater in the group receiving immediate modifie d feeding. Patients who received ORT and immediate modified feeding ap peared to gain more weight than the infants who were starved for 24-48 h, but this difference was not statistically significant. Conclusion. Immediate modified feeding is safe and effective, and may have nutrit ional advantages over traditional ORT with starvation. A similar but m ulticentre study using unmodified diet, i.e. child's normal diet, is b eing carried out by a working group of The European Society of Paediat rics, Gastroenterology and Nutrition (ESPGAN).