Meeting NewsPerspective

Addition of bovine colostrum reduces frequency, duration of acute diarrhea

ORLANDO, Fla. — Young children with acute diarrhea were more likely to have reduced frequency and duration of stools when they were administered bovine colostrum in combination with standard therapy, according to research presented at the AAP National Conference & Exhibition. Researchers said these results were also observed when children had rotavirus and Escherichia coli infection.

The researchers noted that WHO strongly encourages nutritional interventions, such as breastfeeding, during diarrheal illness because pathogen-specific antibodies and numerous compounds can assist in intestinal healing. However, Barakat and colleagues suggested bovine colostrum — milk produced by cows for the first several days following birthing — can mimic the benefits of breastfeeding.

Researchers conducted a randomized, double-blind, placebo-controlled trial to determine the efficacy of this therapy for children with acute diarrhea. The study included 160 Egyptian children aged 6 months to 2 years, all of whom had acute diarrhea for less than 48 hours. Those who had diarrhea for more than 48 hours, dysentery, other systemic infections or malnutrition and those who had previously been administered antibiotic or antidiarrheal treatment were excluded from the study.

Half of the children included were randomly assigned to receive standard therapy in addition to one sachet of bovine colostrum (ImmunoGuard 3g, AdvoCare) daily for 1 week, whereas the other children received standard therapy plus a placebo. At the start of the trial, all infants had comparable signs and symptoms of illness, including frequency and duration of diarrhea and vomiting, fever, hydration levels and original Vesikari scores.

The frequency of stools in children who received bovine colostrum decreased significantly (seven daily vs. 2.5 daily) after 48 hours of treatment. Standard care also decreased the frequency of stools (seven daily vs. three daily). However, more than half of children (65%) who received bovine colostrum had no diarrhea after 72 hours of treatment, and most children in the placebo group — approximately 94% — still had diarrhea. The researchers also observed significantly lower Vesikari scores after 48 hours among children who received bovine colostrum, and the children’s diarrhea resolved significantly earlier, whether it was related to rotavirus (median, 3 days vs. 6 days) or E. coli infection (median, 3 days vs. 6 days). – by Katherine Bortz

Reference:

Barakat SHM, et al. Bovine colostrum in the treatment of acute diarrhea in Egyptian children: a randomized, double-blinded, placebo-controlled trial. Presented at: AAP National Conference & Exhibition; Nov. 2-6, 2018; Orlando, Fla.

Disclosures: Infectious Diseases in Children was unable to confirm relevant financial disclosures prior to publication.

ORLANDO, Fla. — Young children with acute diarrhea were more likely to have reduced frequency and duration of stools when they were administered bovine colostrum in combination with standard therapy, according to research presented at the AAP National Conference & Exhibition. Researchers said these results were also observed when children had rotavirus and Escherichia coli infection.

The researchers noted that WHO strongly encourages nutritional interventions, such as breastfeeding, during diarrheal illness because pathogen-specific antibodies and numerous compounds can assist in intestinal healing. However, Barakat and colleagues suggested bovine colostrum — milk produced by cows for the first several days following birthing — can mimic the benefits of breastfeeding.

Researchers conducted a randomized, double-blind, placebo-controlled trial to determine the efficacy of this therapy for children with acute diarrhea. The study included 160 Egyptian children aged 6 months to 2 years, all of whom had acute diarrhea for less than 48 hours. Those who had diarrhea for more than 48 hours, dysentery, other systemic infections or malnutrition and those who had previously been administered antibiotic or antidiarrheal treatment were excluded from the study.

Half of the children included were randomly assigned to receive standard therapy in addition to one sachet of bovine colostrum (ImmunoGuard 3g, AdvoCare) daily for 1 week, whereas the other children received standard therapy plus a placebo. At the start of the trial, all infants had comparable signs and symptoms of illness, including frequency and duration of diarrhea and vomiting, fever, hydration levels and original Vesikari scores.

The frequency of stools in children who received bovine colostrum decreased significantly (seven daily vs. 2.5 daily) after 48 hours of treatment. Standard care also decreased the frequency of stools (seven daily vs. three daily). However, more than half of children (65%) who received bovine colostrum had no diarrhea after 72 hours of treatment, and most children in the placebo group — approximately 94% — still had diarrhea. The researchers also observed significantly lower Vesikari scores after 48 hours among children who received bovine colostrum, and the children’s diarrhea resolved significantly earlier, whether it was related to rotavirus (median, 3 days vs. 6 days) or E. coli infection (median, 3 days vs. 6 days). – by Katherine Bortz

Reference:

Barakat SHM, et al. Bovine colostrum in the treatment of acute diarrhea in Egyptian children: a randomized, double-blinded, placebo-controlled trial. Presented at: AAP National Conference & Exhibition; Nov. 2-6, 2018; Orlando, Fla.

Disclosures: Infectious Diseases in Children was unable to confirm relevant financial disclosures prior to publication.

    Perspective
    Andi L. Shane

    Andi L. Shane

    This study is one of many that has been conducted over the past 2 and a half decades evaluating the impact of bovine colostrum on gastrointestinal and respiratory infections. Results of a meta-analysis of seven randomized controlled trials (RCTs) on the effect of bovine colostrum in children with acute diarrhea presented at the 2015 AAP National Conference & Exhibition did not show a significant effect on stool output; however, three of the seven RCTs did show a significant reduction in stool frequency, and six of the seven RCTs showed that bovine colostrum significantly reduced the duration of diarrhea. This efficacy study, conducted in Egypt, concluded that there was a reduction in the duration and frequency of diarrheal stools attributed to rotavirus and/or E. coli in 80 children who received bovine colostrum supplementation via a commercial product compared with 80 children who received a placebo. The generalizability of these results to children of younger and older ages, with symptoms beyond 48 hours, who received antibiotic or antidiarrheal therapies, is unknown. However, other studies have assessed the impact of bovine colostrum on children with some of these conditions. Of note, human milk intake, which has been shown to have a beneficial effect on both prevention of diarrheal illness and is encouraged to be continued during acute episodes was not described in this abstract.

    Reference:

    Lu RN. A meta-analysis on the effect of bovine colostrum in children with acute diarrhea. Presented at: AAP National Conference & Exhibition; Oct. 24-27, 2015; Washington, D.C.

    • Andi L. Shane, MD, MPH, MSc
    • Associate professor of pediatrics and interim division chief,
      division of pediatric infectious disease
      Marcus Professor of Hospital Epidemiology and Infection Control
      Emory University School of Medicine
      Children’s Healthcare of Atlanta

    Disclosures: Shane reports no relevant financial disclosures.

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