Chew F, Penna F J, Peret Filho L A, Quan C, Lopes M C, Mota J A, Fontaine O
Instituto de Nutricion de Centro America y Panama (INCAP), Guatemala City,
Lancet. 1993 Jan 23;341(8839):194-7. doi: 10.1016/0140-6736(93)90063-m.
There is concern that feeding full-strength animal milk to infants aged less than 6 months with diarrhoea may have adverse consequences. We assessed the effects on clinical course of two feeding regimens in 159 Guatemalan and Brazilian infants aged 2 weeks to 6 months who had had acute diarrhoea for 120 h or less, showed signs of mild to moderate dehydration, and had no complications. After correction of dehydration, infants were assigned randomly to receive continued full-strength milk feeding or initial feeding with diluted milk with regrading to full-strength milk over 48 h. There were no significant differences between feeding groups in rate of treatment failures (-1%, 95% Cl -14 to 12%) or mean (SD) total stool output (full-strength milk 335 [268] g/kg, diluted milk 338 [354] g/kg) and duration of diarrhoea (92 [50] vs 92 [44] h). A significant association was found between presence of reducing substances in stools and treatment failure (OR 4.3, 95% CI 1.1 to 16.8), but reducing substances in stools were common both in treatment successes (61%) and in failures (87%). Our study supports the conclusion that, for infants under 6 months of age with diarrhoea whose only food is animal milk or formula, the milk or formula normally given should be provided in full strength as soon as dehydration has been corrected.
有人担心，给6个月以下腹泻婴儿喂食全浓度动物奶可能会产生不良后果。我们评估了两种喂养方案对159名危地马拉和巴西婴儿临床病程的影响，这些婴儿年龄在2周龄至6月龄之间，急性腹泻持续时间为120小时或更短，有轻度至中度脱水迹象且无并发症。在纠正脱水后，婴儿被随机分配接受持续全浓度牛奶喂养，或最初喂食稀释牛奶，并在48小时内逐渐过渡到全浓度牛奶。两组喂养方式在治疗失败率（-1%，95%可信区间-14%至12%）、平均（标准差）总粪便排出量（全浓度牛奶组335[268]g/kg，稀释牛奶组338[354]g/kg）和腹泻持续时间（92[50]小时对92[44]小时）方面无显著差异。发现粪便中存在还原物质与治疗失败之间存在显著关联（比值比4.3，95%可信区间1.1至16.8），但治疗成功组（61%）和失败组（87%）粪便中还原物质都很常见。我们的研究支持以下结论：对于6个月以下腹泻且唯一食物为动物奶或配方奶的婴儿，一旦纠正脱水，应尽快提供通常给予的全浓度奶或配方奶。
