Li J, Xu YW, Jiang JJ, Song QK. Bovine colostrum and product intervention associated with relief of childhood infectious diarrhea. Sci Rep. 2019;9(1):3093.
To evaluate the efficacy of bovine colostrum in the prevention and treatment of childhood infectious diarrhea
Meta-analysis of 5 randomized controlled trials (RCTs)
The meta-analysis included 324 children pooled from 5 RCTs. Ninety-seven of the children were healthy infants; 120 were children admitted to the hospital with diarrhea from rotavirus; 27 were hospitalized children diagnosed with diarrhea from E coli; and 80 were outpatient children diagnosed with diarrhea from rotavirus.
Study Parameters Assessed
The researchers searched the literature on bovine colostrum and found 5 RCTs that met the inclusion criteria and investigated the use of bovine colostrum as a therapeutic agent in either preventing or treating childhood infectious diarrhea.
Primary Outcome Measures
Stool frequency, detection of pathogen in the stool, and number of patients with diarrhea at the conclusion of the study
The pooled outcomes of these studies demonstrated a few different findings based on which outcome measure was being used. Overall, there was a reduction in stool frequency of 1.42 stools per day in children experiencing infectious diarrhea and a 77% reduction in pathogens found in the stool. Additionally, when children used bovine colostrum as a preventative agent, there was a significant reduction in the chance of their becoming symptomatic, with a pooled OR of 0.29.
Research that expands our toolkit against infectious diseases, especially in pediatrics, is always exciting. Since infectious diarrhea causes 2 million to 3 million deaths per year in young children, novel treatments are welcome.1 We can take the findings from this article as a necessary first step in establishing the potential for bovine colostrum to be an effective tool. But while the findings are promising, we need to make some careful considerations when translating them into practice.
First, none of the RCTs used commercially available products. All had their colostrum specially produced for the study. Most were processed to a final standardized product, although 1 study gave the colostrum directly without processing. In addition, 4 of the 5 studies used colostrum from hyperimmune cows (cows that had been given vaccinations against specific strains of either E coli or rotavirus during the end of their pregnancy). This is hardly comparable to the commercial colostrum products most of us have access to.
Since infectious diarrhea causes 2 million to 3 million deaths per year in young children, novel treatments are welcome.
Also, along with a lack of standardization in preparation came a lack of standardization in dosing. One study used a total of 10 g of colostrum per day; another used 7 g 3 times per day; and another dosed at 0.5 g/kg, which would put a 20-lb (9.07-kg) child at a dose of about 4.5 g per day.
Third, this study pooled data on both prevention and treatment, as well as pooling significant differences in patient type and patient age. While this created a more robust sample size (n=324), the nonspecificity in timing and populations renders the conclusions less clinically useful.
In addition, when using any animal-derived products, we must consider ethical and environmental implications. We would want to be quite specific in the sourcing of bovine colostrum to ensure that it comes from humane and environmentally responsible producers.
Now to the good news: Colostrum is considered to be quite safe—technically more food than pharmaceutical. Despite the limitations of the meta-analysis reviewed here, there seems to be a potential for colostrum in the prevention and treatment of childhood diarrhea. However, the question remains if commercially available products will yield favorable results. Further study is needed.
While human studies are still lacking, there is some compelling in vivo and animal research suggesting that commercially available colostrum may be helpful in binding with viruses and bacteria, modulating immune activity, and reducing lipopolysaccharide (LPS) damage.2 Since the risks and side effects associated with the use of colostrum appear to be quite low, inquisitive doctors may be inclined to put this intervention to the clinical test.
However, we would also be remiss to forget our 2 top treatments in the prevention of infectious diarrhea in young children: breastfeeding and the rotavirus vaccine, both of which are effective at primary prevention.3,4