Acute gastroenteritis in infants under 6 months old

Article Abstract:

Infants with gastroenteritis (inflammation of the stomach and intestines) usually undergo a period of starvation and rehydration. This is followed by the gradual reintroduction of milk feedings in a practice known as regrading. Although regrading was previously used to prevent abnormal absorption of carbohydrates, immediate reintroduction of full strength foods is now recommended in children over six months of age. Oral rehydration solutions are prescribed to 80 percent of children with gastroenteritis in the United Kingdom. The inability to absorb carbohydrates commonly occurs as lactose intolerance. However, the incidence of lactose intolerance appears to be decreasing. The benefits of gradual refeeding in infants less than six months was assessed with respect to recurrence of diarrhea due to lactose intolerance, effect on weight, and length of hospital stay. Sixty-two babies with gastroenteritis, who were under six months of age, received rehydration fluids and were refed either gradually or immediately. Recurrence of diarrhea due to lactose intolerance, effect on weight, and duration of hospital stay were similar for all babies. Diarrhea recurred in 26 babies after refeeding, and they were given lactose free soy-based formula. Immediate feeding with full strength formulas was shown to be beneficial for well nourished babies with mild to moderately severe gastroenteritis. These results demonstrate that babies with lactose intolerance may be fed with lactose-free soy-based formula as an alternative to regrading with regular infant formulas. (Consumer Summary produced by Reliance Medical Information, Inc.)

Pediatric diseases, Infant formulas, Lactose intolerance, Lactose intolerance in children

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Management of gastroenteritis

Article Abstract:

Infectious gastroenteritis is the inflammation of the stomach and intestines due to infection with a microorganism. It causes extensive disease in children and accounts for a major proportion of pediatric hospital admissions. A previous study reported that gastroenteritis is associated with frequent complications and that the infecting microorganism is identified in only 16 percent of cases. However, awareness of the disease has increased and diagnosis has improved, permitting the identification of new infecting microorganisms. Infant feeding and oral rehydration are an important part of the management of gastroenteritis in children. According to current studies, gastroenteritis is now associated with fewer complications and the infecting microorganism is identified in 75 percent of cases. The severity of gastroenteritis, infecting microorganisms, incidence of complications, and management of this illness were assessed in 215 affected infants and children. Infecting microorganisms in the stools were identified in 125 cases, and included viruses in 64, bacteria in 30, protozoa in 19, and multiple microorganisms in 11. Although the incidence of complications was low, prolonged diarrhea occurred in 24 cases. In addition, 77 children were treated inappropriately before hospital admission. These results indicate that gastroenteritis is mild in the early phase, but tends to be managed inappropriately before admission to the hospital. Gastroenteritis may also be associated with prolonged diarrhea. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Causes of

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Management of infantile gastroenteritis

Article Abstract:

The rate of death due to infantile gastroenteritis (inflammation of the stomach and intestines in infants) has decreased in developed countries. This is mainly due to a reduction in the incidence of hypernatremic dehydration, or water loss due to high blood levels of sodium. Oral rehydration therapy is an important part of the management of infantile gastroenteritis. The strategy for refeeding babies after gastroenteritis and the need for special formulas have not been clearly established. Previously, children with gastroenteritis were given a solution with glucose (sugar) for 24 hours and the infant's usual feeding was reintroduced gradually in a procedure known as regrading. However, immediate return to the infant's feeding is now recommended, particularly for breast-fed babies and formula-fed infants less than six months old. The procedure of regrading was used to avoid certain complications of gastroenteritis, such as lactose intolerance (the inability to digest milk) and allergy to cow's milk. However, modern adapted milks consist of less sensitizing formulas. Although the use of lactose-free soy formula is recommended after gastroenteritis, soy may cause damage to the small intestine in early infancy. The management of lactose intolerance due to gastrointestinal infection is described. Persistent diarrhea on cow milk feeding should be investigated by examination of the stool and possibly by biopsy of the small intestine. (Consumer Summary produced by Reliance Medical Information, Inc.)

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