Value of a Chicken-Based Formula for Refeeding of Children with Protracted Diarrhea and Malnutrition in a Developing Country

Two hospital-made, lactose-free, hypoosmolar formulas were compared for therapy for 61 children aged 10–28 months who had severe malnutrition and protracted diarrhea. The formulas were isocaloric and contained dextrin-maltose, carrots, sunflower oil, minerals, and vitamins. One had chicken meat as the protein source and the other had hydrolyzed lactalbumin (LAD). Initially the formulas were given as a continuous enteral feeding by nasogastric tube and pump. Six patients died from metabolic and infectious complications; four failed to equilibrate and changed diet. The remaining 51 were divided into two groupsgroup A, chicken formula (n = 26), and group B, LAD formula (n = 25). The mean duration of diarrhea was similar in both groupsnumber of days with liquid stools = 6.0 ± 4.1 in group A, 5.5 ± 2.8 in group B; number of days with >4 stools/day = 3.5 ± 3.4 in group A, 4.1 ± 2.1 in group B. The time until beginning nutritional recovery was 13.2 ± 12.0 days in group A and 13.3 ± 7.8 days in group B. Intercurrent infections were significantly more frequent in patients receiving chicken formula (12 of 30 patients) than in those receiving LAD formula (4 of 27 patients) (p < 0.05). We conclude that chicken formula is an efficient substitute to expensive semielemental formulas for continuous enteral feeding of protracted diarrhea in severely malnourished children.