All issues > Volume 38(7); 1995

Original Article

J Korean Pediatr Soc. 1995;38(7):936-945. Published online July 15, 1995.

Intractable Diarrhea in Early Infancy : Clinical Features on Admission and A Nutritional Management

Jong Won JW Shin¹, Kyung Won KW Hwang¹, Young Ho YH Ahn¹, Jin Bok JB Hwang¹, Chang Ho CH Han¹, Hai Lee HL Chung¹, Young Dae YD Kwon¹

¹Department of Pediatrics, Taegu Catholic University School of Medicine, Taegu, Korea

Abstract

Purpose
: We studied to assess the value of clinical findings on admission in screening of intractable diarrhea in early infancy(IDI) and the efficiency of early trial of semi-elemental form-ula (protein hydrolysate) as a nutritional management in IDI.
Methods
: We carried out a retrospective review of medical records of twenty-eight early infants with diarrhea and malnutrition who were diagnosed as IDI at Department of Pediatrics, Taegu Catholic University Hospital between January 1990 and May 1993.
Results
: 1) The mean age of the patients was 28.914.5(10 - 86)days. The duration of diarrhea on admission was 66.1(1 - 30)days. Twenty-four cases(85%) were below 3 percentile in body weight on admission and no patients was fed breast milk over 7 days after birth. 2) Laboratory data on admission showed serum protein level 4.80.5(3.7 - 6.1) g/dl, serum albumin level 2.20.3(1.8 - 3.3)g/dl, serum bicarbonate level 11.35.7(2.7 - 22.3) mEq/L and band form of leukocytes on the peripheral blood smear was 23.715.6(4 - 64) %. 3) Necrotizing enterocolitis was developed in 5(18%) cases and the incidence was much more common in patients with 'Not-Tried' or 'Not-Early Tried' of semi-elemental formula as a nutritional management(p<0.05). 4) 'Early Tried' patients with semi-elementa formula showed rapid improvement in body weight and thriving, early remission, lower incidence of necrotizing enterocolitis and motality than other groups(p<0.05).
Conclusion
: IDI must be considered and early trial of semi-elemental formula can be recommended if a young infant suffered from diarrhea and malnutrition shows features of ① body weight<3 percentile ②serum albumin<3.0g/dl ③ band neutrophil>5% on peripheral blood smear on admission.

Keywords :Early infancy, Intractable, Diarrhea, Protein hydrolysate