Dietary management of childhood diarrhea in low- and middle-income countries

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Among children in low- and middle-income countries, where the dual burden of diarrhea and malnutrition is greatest and where access to proprietary formulas and specialized ingredients is limited, the use of locally available age-appropriate foods should be promoted for the majority of acute diarrhea (AD) cases.

There is still some debate around the current guidelines on the treatment of diarrhea in children from low- and middle-income countries. This review aimed to assess randomized controlled trials evaluating food-based interventions among children under five years old with diarrhea in low- and middle-income countries. Data from twenty-nine studies was included in meta-analysis on the following outcomes; diarrhea duration, stool output, weight gain (WG) and treatment failure risk (TFR) for studies on AD and persistent diarrhea (PD) separately. Evidence of varying qualities was observed in the results. Authors found that diluting/fermenting lactose-containing liquid feeds (LLF) didn’t affect any outcome when compared with an ordinary LLF. Lactose-free feeds were shown to reduce TFR, compared to LLF for AD. Limited evidence on the effects of interventions on PD was available. No effect on any outcomes was observed for other forms of food-based intervention compared to home-available ingredients for AD, nor PD. WG in children with acute diarrhea was shown to be greater among those fed with a home-available diet.

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