Chronic Diarrhea in Infancy

ABSTRACT

Diarrhea is an extremely common cause of morbidity in infancy. Occasionally it becomes protracted, leading to a vicious cycle of malabsorption, malnutrition and failure to thrive. Thirty nine infants of chronic diarrhea who had been admitted to the Department of pediatrics, Yonsei University College of Medicine for 3 years between September, 1989 and December 1992, were clinically studied and analized, the results were as follows 1) The mean age of the patiens was 7.5+/-4.9 months. Symptoms started at 4.0+/-3.4 months of age and lasted for 3.6+/-4.1 months. 2) Among 39 cases, there were 16 cases of secondary lactase deficiency (41%), 9 cases of milk allergy(23%) and 3 cases of rotaviral enteritis(8%). Three patients (8%). had hepatitis and a patient had sepsis. 3) Incidence is much more common in formula-fed infants than brast-fed infants. 4) The growth status of the patients were poor; 54% of the patients by body weight and 39% by height fell into lower 10 percentile of normal distribution. Malnutrition accompanied the majority (82%) of the patients; 46% of mild form, 23% of moderate and 13% of severe form by Gomez classification. 5) Laboratory data on admission showed anemia in 21% of patients, hypoalbuminemia in 13% and hypocholester olemia in 31%. 6) Thirty one percent of the patients were improved with conservative tratment only. 33% of the patients got improved by low lactose milk feeding and milk withdrawl was done in 23% of the patients. Total parenteral nutrition was performed in 13% of the patients. All patients were cured with the treatment. With the above results, the most common cause of chronic diarrhea in infancy is postinfectious disaccharidase deficiency. followed by milk allergy. Low lactose milk feeding and milk withdrawl can improve the infants from chronic diarrhea.