Use of undiluted whole cow's milk is effective for the routine treatment of children with acute diarrhea and severe dehydration.

A comparison is made between two groups of children aged 1-24 months and admitted to a teaching University Hospital due to acute diarrhea and severe dehydration. One group (n = 119) received a diluted cow's milk formula and the other (n = 109) a full-strength formula. Duration of diarrhea was similar: In the group that received full-strength milk weight gain was greater during diarrhea (5.03 vs. 1.80 g/kg/day, P < 0.01) and during the hospital stay (5.39 vs. 2.33 g/kg/day, P < 0.001). Weight for height z-scores and weight for height as percentage of median improved during the hospital stay only in the group that received the full-strength formula. Full-strength cow's milk seems to be an adequate routine regimen even for children with acute diarrhea that must be treated for severe dehydration. In developing countries diarrhea and dehydration are a disease of small children. As rates of exclusive breast feeding are low, mainly in the urban setting, cow's milk is the main and sometimes the only food available. Lactose-free formulae are priced out of reach of the poor people and in Latin America there is no accepted tradition for use of fermented milk products. Our study is an indication that use of undiluted cow's milk may be effective for the routine treatment of acute diarrhea in children that must be treated as inpatients due to severe dehydration.