Lactose avoidance for young children with acute diarrhoea

Area of Science:

• Pediatrics
• Gastroenterology
• Infectious Diseases

Background:

• Acute diarrhea in young children can lead to temporary lactase deficiency, impairing lactose digestion.
• Impaired lactose digestion may exacerbate or prolong diarrheal illness.
• The benefit of lactose avoidance in acute diarrhea management remains uncertain.

Purpose of the Study:

• To evaluate if reducing or avoiding lactose intake shortens diarrhea duration and severity in young children.
• To assess other indicators of morbidity and overall mortality associated with lactose intake during acute diarrhea.

Main Methods:

• Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
• Searched multiple databases including Cochrane, MEDLINE, EMBASE, and LILACS up to May 2013.
• Included trials involving children under five with acute diarrhea, assessing lactose-free or diluted lactose interventions.

Main Results:

• Lactose-free products may reduce diarrhea duration by approximately 18 hours (low-quality evidence).
• Lactose-free diets likely halve the risk of treatment failure (moderate-quality evidence).
• Diluted lactose milk showed potential to reduce treatment failure but not duration (low-quality evidence).

Conclusions:

• A lactose-free diet may lead to earlier resolution of acute diarrhea and reduced treatment failure in non-breastfed young children.
• Diluting lactose-containing formulas might offer benefits, but further trials are necessary.
• A significant gap exists in research from low-income countries where diarrhea mortality and malnutrition are high.