Hi Netters,

I just received my Pediatrics journal (December 1996, Vol. 98, #6) in the
mail today. In stead of the usual, putting the journal in my "to read" box, I
glanced over the articles and found an interesting one.  "Efficacy of
Milk-based Diets in Persistent Diarrhea:  A Randomized Controlled Trial" by
Bhatnagar, DNB, PhD,  Singh, MBBS,  Bhan, MD,  Saxena, DCH, and Shariff, MD.
 I want to post a few sentences that I found very disturbing. "It is well
established that persistent diarrhea (PD) causes 39% to 40% of all
diarrhea-associated deaths in developing countries."  A significant
proportion of infants with PD are not breastfed, and beyond infancy breast
milk output is inadequate to meet the nutritional requirements of those who
are breastfed.  A highly contentious issue is whether milk should be totally
withdrawn in PD, because in developing countries commercial lactose-free
formulations are not easily available or affordable.  Until recently, it was
widely thought that avoidance of milk during acute diarrhea decreases
postenteritis complications, particularly in infants."  Another paragraph
later "Furthermore, other dietary components, such as cereals, by delaying
the gastric emptying time slow down the release of lactose in the intestine
and result in its better absorption from milk-cereal mixtures than when the
same amount of milk is given alone."  "Apart from lactose intolerance,
concern about milk protein allergy has been the basis for recommending total
milk elimination in PD.  Because our patients tolerated milk 4 to 6 weeks
after discharge, it seems that in our setting , and in the type of patients
enrolled in the study, milk protein allergy is not a major concern."  What do
you think about that Maureen M. ??????  Infants between the ages of 3 months
to 24 months were enrolled in the study.  The conclusion was "total
elimination of milk is not required in the initial treatment of patients with
PD in developing countries, and reduction rather than elimination of milk
will be requuired in patients whose diets are predominantly based on animal
milk.  In addition, these milk-cereal mixtures are easy to prepare in the
household."  NOTHING was said about breastfeeding nor breastmilk.  Settle
down Pat.  It is only an article---that goes out to MANY pediatricians. Oh,
yuk.

Pat Bull, RN, IBCLC
The Breastfeeding Connection/Medela, Inc
Naperville, IL- where it is to hit 50's on Weds.