Abstract
Background: Diarrhea continues to be a prominent contributor to morbidity and mortality among young children under five years, especially in developing nations. Secondary lactose intolerance is a significant complication that can arise from acute diarrhea. However, it can be effectively managed with lactose-free formula.
 Objective: This study aimed to compare the rate of diarrhea resolution within a 24-hour period among children receiving lactose-free formula and those receiving lactose-containing formula.
 Methods: This retrospective cohort study took place at Naresuan University Hospital and included 153 children aged between one month and five years admitted with acute diarrhea. Participants with bloody mucous diarrhea suspected to be bacterial in nature, positive stool culture, breastfeeding and chronic diarrhea (including cow’s milk protein allergy and inflammatory bowel disease) were excluded. We compared the effectiveness of lactose-free formula (n=48) and lactose-containing formula in improving clinical diarrhea within a 24-hour (n=105).
 Results: The study findings indicated the lactose-free formula group demonstrated a statistically significant increase in efficacy, with a 3.90 fold improvement in diarrhea within 24 hours compared with that of the group receiving lactose-containing formula. These results were obtained after the confounding factors were adjusted using multivariable regression analysis. The adjusted relative risk (RR) for a 24-hour improvement in diarrhea was 3.90 (95% CI: 1.91-7.95). However, this study encountered limitations regarding the sample size and accurate measurement of stool output.
 Conclusion: Lactose-free formula showed the potential for greater effectiveness in improving acute diarrhea within a 24-hour timeframe compared with lactose-containing formula.
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