Randomised trial of different rates of feeding in acute diarrhoea

OBJECTIVE To compare the effect of different feeding frequencies on the speed of recovery from diarrhoea. METHODS A randomised, non-blinded trial provided 0.452 MJ/kg/day as either 6 or 12 feeds of cows9 milk each day to 262 hospitalised male infants aged 3–12 months with acute diarrhoea. Stool frequency, stool weight, body weight, and diarrhoea complications were monitored until recovery or for 14 days. RESULTS A proportional hazards regression model controlling for age, diarrhoea aetiology, and severity of dehydration on admission revealed that the frequently fed group had a significantly shorter duration of diarrhoea (hazards ratio, 1.29; 95% confidence interval, 1.002 to 1.653). Frequently fed infants had a significantly greater weight gain and significantly lower faecal frequency and faecal weight. CONCLUSIONS Breast feeding remains the preferred method of feeding infants with acute diarrhoea, but feeding cows9 milk to adequately nourished infants with acute diarrhoea is safe and is more rapidly effective if provided in frequent feeds with low energy loads. Key messages In adequately nourished infants 3 to 12 months of age with acute diarrhoea, it is safe to feed cows9 milk at either the standard frequency (six feeds each day) or at a higher frequency For adequately nourished infants with acute diarrhoea who are bottle fed cows9 milk, the simple clinical manoeuvre of decreasing the volume of each feed and increasing the frequency of feeding (while maintaining the same total daily energy intake) speeds recovery, reduces faecal frequency and faecal weight, and increases weight gain during the recovery period