Chemically defined diet in the treatment of kwashiorkor

The authors report on the treatment of children with kwashiorkor, using Vivonex or Casilan. With Vivonex, all patients were bottle-fed as early as the 2nd or 3rd day, whereas Casilan had to be administered by stomach tube for about a week. Children fed Casilan vomited much more frequently than patients receiving Vivonex. When Casilan was given, the albumin level rose after 8 days, whereas with Vivonex, this did not occur unitl 15 days. On the other hand, only the Vivonex fed children showed an increase of hemoglobin in the first 3 weeks of treatment. With Vivonex, the patients reached their minimum weight much faster and at a lower albumin level than with Casilan. In both groups, the frequency of diarrhea was similar; the relatively high glucose concentration of Vivonex and the disturbance of resorption, even of monosaccharides, which is frequently observed in severe cases of kwashiorkor may be responsible for the diarrhea of the children receiving Vivonex.