Parenteral and oral alimentation in the treatment of the nonspecific protracted diarrheal syndrome of infancy

Abstract

Clinical experience in the management of 10 infants who had protracted diarrhea which started before 3 months of age is presented. The first 7 patients died; clearly identifiable pathologic entity was not established as a cause of the diarrhea, and treatment was ineffectual. The last 3 patients were initially evaluated in accord with a prearranged diagnostic protocol and then were started on a therapeutic regimen which included intravenous administration of hypertonic solutions of protein hydrolysate, dextrose, and alcohol and oral feedings of medium-chain triglycerides. This regimen could supply up to 400 calories per kilogram per day. The infants grew and developed while on this treatment and tolerated it for periods of up to 18 weeks without any serious problems. A specific cause for the diarrhea in the 3 infants who recovered could not be demonstrated. However, after recovery, each had an adverse reaction temporally associated with the change from Nutramigen to Enfamil or whole milk feedings, thus suggesting the presence of milk protein allergy.