Suche
Relation
Li J, Xu YW, Jiang JJ, Song QK. Bovine colostrum and product intervention associated with the relief of infectious diarrhea in children.Scientific Rep. 2019;9(1):3093.
Study objective
To evaluate the effectiveness of bovine colostrum in the prevention and treatment of childhood infectious diarrhea
Draft
Meta-analysis of 5 randomized controlled trials (RCTs)
Participant
The meta-analysis included 324 children from 5 RCTs. 97 of the children were healthy infants; 120 children were hospitalized with rotavirus diarrhea; Diarrhea was diagnosed in 27 hospitalized childrenE. coli; and 80 were outpatient children diagnosed with rotavirus diarrhea.
Study parameters assessed
Researchers searched the literature on bovine colostrum and found 5 RCTs that met the inclusion criteria and examined the use of bovine colostrum as a therapeutic agent to prevent or treat infectious diarrhea in children.
Primary outcome measures
Stool frequency, detection of pathogens in stool and number of patients with diarrhea at the end of the study
Key insights
The pooled results of these studies showed some different results depending on which outcome measure was used. Overall, children with infectious diarrhea experienced a reduction in stool frequency of 1.42 bowel movements per day and a 77% reduction in pathogens found in stool. When children used bovine colostrum as a preventive agent, they were significantly less likely to become symptomatic, with a pooled OR of 0.29.
Practice implications
Research that expands our tools against infectious diseases, especially in pediatrics, is always exciting. Because infectious diarrhea causes 2 to 3 million deaths in young children each year, novel treatments are welcome.1We can consider the findings from this article as a necessary first step in determining the potential of bovine colostrum as an effective tool. But while the results are promising, we need to make some careful considerations when putting them into practice.
First, none of the RCTs used commercially available products. All had their colostrum made specifically for the study. Most were processed into a standardized final product, although 1 study reported the colostrum directly without processing. In addition, 4 of the 5 studies used colostrum from hyperimmune cows (cows that had been vaccinated against specific strains of bothE. colior rotavirus at the end of pregnancy). This hardly compares to the commercial colostrum products that most of us have access to.
Because infectious diarrhea causes 2 to 3 million deaths in young children each year, novel treatments are welcome.
With a lack of standardization in preparation came a lack of standardization in dosage. One study used a total of 10g of colostrum per day; another used 7g 3 times per day; and another at a dosage of 0.5 g/kg, which would give a 20 lb (9.07 kg) child a dose of about 4.5 g per day.
Third, this study summarized data on both prevention and treatment, pooling significant differences in patient type and patient age. While this resulted in a more robust sample size (n = 324), the nonspecificity in timing and populations makes the conclusions less clinically useful.
In addition, we must consider ethical and environmental impacts when using products of animal origin. We want to be very specific when sourcing bovine colostrum to ensure it comes from humane and environmentally conscious producers.
Now for the good news: Colostrum is considered fairly safe – technically more food than medicine. Despite the limitations of the meta-analysis reviewed here, colostrum appears to have potential for preventing and treating diarrhea in children. However, the question remains whether commercially available products produce favorable results. Further studies are required.
While human studies are still lacking, there are some compelling in vivo and animal studies that suggest that commercially available colostrum may be helpful in binding to viruses and bacteria, modulating immune activity, and reducing lipopolysaccharide (LPS) damage.2Since the risks and side effects associated with colostrum use appear to be quite low, curious doctors may be inclined to put this procedure to clinical trial.
However, we would also be remiss to forget our 2 most important treatments for preventing infectious diarrhea in young children: breastfeeding and the rotavirus vaccine, both of which are effective in primary prevention.3.4