Diarrhoea: after rehydration, what next?

Successful management of diarrhoea depends firstly on restoring fluid and electrolyte balance. Following this, the child needs to be fed, to prevent malnutrition and morbidity. Conventionally, this is achieved by regrading onto the previous feed. In our series of 42 infants with mild gastroenteritis, six out of 12 infants had persistent diarrhoea after one week on normal infant formula. Twenty-five out of 27 infants who were given a low-lactose formula (HN25) had normal stools within 4 days. (chi2 = 18.487; P less than 0.001). Only two out of 27 infants had a recurrence of loose stools at 1 week and these became normal after regrading back on to HN25. Recovery time was shortened, while nutritional status was maintained. Short-term substitution of a low-lactose formula after rehydration speeds recovery from gastroenteritis.