Does yogurt decrease acute diarrhoeal symptoms in children with acute gastroenteritis
Date First Published:
June 8, 2007
Last Updated:
June 8, 2007
Report by:
Kevin Mackway-Jones, Professor of Emergency Medicine (Manchester Royal Infirmary)
Search checked by:
tbc, Manchester Royal Infirmary
Three-Part Question:
In [an otherwise healthy 18 month child presenting with acute diarrhoea] does the [introduction of yoghurt feeds] aid [recovery]?
Clinical Scenario:
An 18 month old child presents to the Emergency Departmentwith diarrhoea following what sounds like an acute episode of gastroenteritis. She is not significantly dehydrated and can tolerate fluids orally. Mum is concerned as the child has an increasingly sore nappy area and because "things just go straight through her". You have heard that live yogourt and probiotics can be helpful and recommend this to the mother. When you mention this to your junior colleagues later they look at you sadly and shake their heads. Self-doubt sets in and you decide to look for the evidence to show them who knows best
Search Strategy:
Ovid Medline 1950 - May 2007
Search Details:
[exp Diarrhea OR Diarrhea.mp OR Diarrhoea.mp] AND [Yogurt.mp OR Yogourt.mp]
Outcome:
71 papers found of which 7 relevant to the clinical question
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Effect of feeding youhurt versus milk in children with persistent diarrhoea Boudraa G, Touhami M, Pochart P et al 1990 Algeria | 45 children aged 3 - 36 months with persistent diarrhoea. Fed milk or yogurt for 5 days | Controlled trial | 5% weight loss or diarrhoea at 5 days | 42% vs 14% (P < 0.05) | Small numbers |
| A human Lactobaccilus strain (Lactobaccilus casei sp strain CG) promotes recovery from acute diarrhea in children Isolauri E, Juntunen M, Rautanen T et al 1991 Finland | 71 children aged 4 - 45 months given Lactobacillus casei sp strain CG, Gefilac 125 g fermented milk product bd. Lactobacillus casei sp strain CG freeze dried bd or pasteurised yogurt 125g bd | RCT | Duration of diarrhoea (days) | 1.4 (0.8) vs 1.4(0.8) vs 2.4 | |
| Nutitional management of persistent diarrhea: factors predicting clinical outcome Bhutta ZA, Molla AM, Issani Z et al 1992 Pakistan | 73 children aged 6 - 36 months with persistent diarrhea given Khitchri (rice-lentil) diet supplemented with yoghurt or soy formula | Controlled trial | Paper awaited | ||
| Lactocaccilus casei in the control of acute diarrhea - a pilot study Agarwal KN, Bhasin SK, Faridi MM et al 2001 India | Paper awaited | ||||
| Effect of feeding yoghurt versus milk in children with acute diarrhea and carbohydrate malabsorption Boudraa G, Benbouabdellah M, Hachelaf W et al 2001 Algeria | 112 children aged 3 - 24 months with acute acute watery diarrhea admitted to the hospital. infant formula (56) vs the same formula fermented with Lactobaccilus bulgaricus and strep thermophilus (56) | RCT | Success rate (cessation of diarrhea and appropriate weight gain at 7 days) | NSD | |
| persistent diarrhea at 2 says | 65% vs 35% | ||||
| Feasibility studies to control acute diarrhea in children by feeding fermented milk preparations Actimel and Indian Dahi Agarwal KN and Bhasin SK 2002 India | 150 patients from hospital and community aged 6 months to 5 years. Fermented milk (Actimel) vs Indian Dahi vs ultra-heat-treated yoghurt | RCT | Decrease in mean duration of diarrhea | 0.3 and 0.6 days in groups 1 and 2 vs group 3 (P<0.001) | |
| Evaluation of yogurt effect on acute diarrhea in a 6 - 24 month-old hospitalized infants Pashapour N and Sariyeh G 2006 Iran | 80 moderately dehydrated hospitalized breast fed infants aged 6 - 24 months with acute non-bloody non-mucoid diarrhea. Children were given 15 ml/kg/day of pasteurised cow milk yoghurt with standard hospital treatments vs standard hospital treatment alone | RCT |
Author Commentary:
There arre a number of studies from around the world that address this issue. Most are small and many use different fermentation agents. The message is, however, consistent
Bottom Line:
Fermented milk products reduce the duration of symptoms in infants with acute non-bloody diarrhoea
Level of Evidence:
Level 2: Studies considered were neither 1 or 3
References:
- Boudraa G, Touhami M, Pochart P et al. Effect of feeding youhurt versus milk in children with persistent diarrhoea
- Isolauri E, Juntunen M, Rautanen T et al. A human Lactobaccilus strain (Lactobaccilus casei sp strain CG) promotes recovery from acute diarrhea in children
- Bhutta ZA, Molla AM, Issani Z et al. Nutitional management of persistent diarrhea: factors predicting clinical outcome
- Agarwal KN, Bhasin SK, Faridi MM et al. Lactocaccilus casei in the control of acute diarrhea - a pilot study
- Boudraa G, Benbouabdellah M, Hachelaf W et al. Effect of feeding yoghurt versus milk in children with acute diarrhea and carbohydrate malabsorption
- Agarwal KN and Bhasin SK. Feasibility studies to control acute diarrhea in children by feeding fermented milk preparations Actimel and Indian Dahi
- Pashapour N and Sariyeh G. Evaluation of yogurt effect on acute diarrhea in a 6 - 24 month-old hospitalized infants