Acute diarrhoea, typically due to bacterial or viral infection, is a
common childhood illness and, in low-income countries, remains an
important cause of death. Over two million children under five years of
age die each year in poorer countries because of acute diarrhoea. In
richer countries, it does not usually cause death but it is a common
reason for young children needing medical advice or hospital admission.
Young children with acute diarrhoea may temporarily be unable to digest
lactose, the most common type of sugar in milk. Inability to digest and
absorb lactose can make the diarrhoea worse and last longer. We looked
for evidence that reducing children's lactose intake, either by feeding
lactose-free milk or by diluting lactose-containing milk, shortens the
duration of diarrhoea and prevents complications such as dehydration.
We looked for research up to 13 May 2013 and included 33 trials in our
analyses. Twenty-two trials compared outcomes for children given a
lactose-free feed with those for children given a lactose-containing
feed and 11 trials compared outcomes for children fed a diluted milk
feed with those for children given an undiluted milk feed.
We found evidence that feeds that do not contain lactose may reduce the
duration of diarrhoea by an average of about 18 hours (low quality
evidence). Lactose-free feeds probably lower the risk of children having
prolonged or worsening diarrhoea (moderate quality evidence).
We did not find any evidence that diluted milk feeds reduce the duration
of diarrhoea (low quality evidence) but these feeds may lower the risk
of children having prolonged or worsening diarrhoea (low quality
The majority of trials excluded breast fed infants, and none were
conducted in low-income countries where diarrhoea can cause death, so
the review is relevant to infants and young children who are receiving
formula or are weaned in high- and middle-income countries.
MacGillivray, S.; Fahey, T.; McGuire, W. Lactose avoidance for young children with acute diarrhoea. Cochrane Database of Systematic Reviews (2013) (Issue 10) Art. No.: CD005433. [DOI: 10.1002/14651858.CD005433.pub2]
Lactose avoidance for young children with acute diarrhoea