Hiruthayadhason Mary Jasmine Sheela, (2015) A Study to determine the incidence of secondary lactose intolerance and evaluate the effect of lactose free feeds in controlling diarrhea and correcting dehydration among children. Doctoral thesis, The Tamil Nadu Dr. M.G.R. Medical University, Chennai.
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Abstract
INTRODUCTION: Diarrhea is the second leading cause of deaths among under five children more than 10 million children die each year from diarrhea. Dehydration remains a major cause of morbidity and mortality in infants and young children. Infants are more susceptible for dehydration. The effect of dehydration is greater because of higher metabolic rate, greater baseline fluid requirement inability to communicate thirst or seek fluid. Dehydration is also associated with electrolyte imbalance. With this idea, the researcher developed a cereal (Rice) and soya based lactose free, homemade feed for infants which effectively controls diarrhea and correct dehydration among children with secondary lactose intolerance and also easily available and digestible, having all essential nutrients for child’s growth and development. AIM AND OBJECTIVE: The present study is aimed to develop a lactose free feed with cereal based (matta red rice) and soya and to evaluate the effectiveness of the developed lactose free feeds in controlling diarrhea and correcting dehydration among children with secondary lactose intolerance induced diarrhea. The first objective of the study was to determine the incidence of secondary lactose intolerance among children. 2. To evaluate the effect of lactose free Risoy feeds in controlling diarrhea and controlling dehydration among children. 3. To find out the correlation between the diarrheal status of children with hydration in Pre-test and Post-test I and Post-test II. METHODS: A quasi experimental study based on ‘before and after’, control group design was used. A total of 120 children aged between 4 months to 12 months were taken as study sample, experimental group (n=60) and control group (n=60) through purposive sampling technique. Prior to this, the incidence of secondary lactose intolerance was assessed, totally 618 children having diarrhea for 3 and more than 3 days were assessed between the age group of 4-12 months. The effectiveness of lactose free Risoy feeds were assessed by administering lactose free Risoy feeds to children among experimental group for 3 days. The day of admission, Day I score is taken as pre-test, and Day II as post-test I and Day III as post-test II. The effectiveness of the feed was determined by comparing with the control group. The tools include Demographic data of the child and mother Observational rating scale for assessing the diarrheal status. Observational rating scale for assessing the hydration status. 5 point likert scale to assess the level of satisfaction regarding Risoy feeds among mothers of children. RESULTS: A total number of 618 children with diarrhea for 3 and more than three days were screened for presence of reducing sugar in stool and stool pH, among which (56.63%) 350 children between the age of 4to 12 months were identified to have secondary lactose intolerance. The scores of Diarrheal status and Hydration status were compared within the group by paired ‘t’ test and between group by independent ‘t’ tests. The Day I assessment was taken as Pre-test and Day II. Post-test I and Day 3 assessment considered as Post-test II. The children were found to improve in all aspects of diarrhea and hydration status on Day III. After the introduction of lactose free RISOY feeds among experimental group. In Post-test I, the total mean post test score of hydration status in all aspects in experimental group is 81.62 is more than the control group mean score 77.93. The calculated ‘t’-value 3.213 is statistically significant at P<.00 level. This indicates that there is a difference between the experimental and control group. The children in experimental group attained better hydration status when compared with the control group. The total mean post test score of diarrheal status in all aspects in experimental group on Post-test I is 66.27 which is less than the control group mean score 74.88. The calculated ‘t’-value -7.952 is statistically significant at P<.00 level. Hence the diarrheal status among experimental group is statistically significant at P<.00 level. This indicates that there is a difference between the experimental and control group. The total mean post intervention score of diarrheal status in all aspects in experimental group on Post-test II is 38.1667 which is less than the control group mean score 41.2778. The calculated ‘t’-value 2.246 is statistically significant at P<.00 level. This shows that there is a difference between the experimental and control group. The total mean post test score of hydration status in all aspects in experimental group on Post-test II is 97.4603 is more than the control group mean score 93.7302. The calculated ‘t’-value 4.445 is statistically significant at P<.032 level. This indicates that there is a difference between the experimental and control group. The hydration status of the children were found to be to the maximum level in most of the subjects among experimental group. Hence the lactose free RISOY feeds were effective in correcting the dehydration by controlling the episodes of diarrhea. There was a negative correlation found between the diarrheal and hydration status was increasing. Regarding the level of satisfaction in utilizing the lactose free Risoy feeds, the mother were not very much satisfied in the pretest and in post-test II, all the mother experienced that, they were very satisfied with the Risoy feeds. CONCLUSIONS: It is clear from the study that the children with secondary lactose intolerance can be effectively managed with Lactose free Risoy feeds among the children between the age of 4 -12 months. The overall importance is to identify the children who suffer from secondary Lactose intolerance and feed them with lactose free diet according to the age group. Prepared with available ingredients, which may control diarrheal episodes and correct dehydration among children between the age group of 4 to 12 months. Proper assessment of diarrheal status with an observational rating scale. With ten assessments that include colour, consistency of quantity of stool, episodes, odor, of stool, blood, for reducing of sugar, anal excoriation, abdominal bloating etc., will guide the nurse to identify the level of diarrhea (high, low very high) and also asses the hydration status of the children with 14 observations like (general conditions, eyes, mouth, tongue, thirst, urine output, tears, skin turgor, fontanels, arms and legs, capillary refill, pulse rate, respiration, blood pressure). Pre interventional assessment on Pre-test is taken as pre-test and two post tests were assessed on Post-test I and Post-test II taken to find out, how effectively the lactose free Risoy feeds controlled diarrhea and corrected the dehydrate among children. The researcher prepared lactose free Risoy feeds, when comparing with the commercial lactose free feeds it is highly nutritious. All the nutrients are preserved in it including minerals like calcium, magnesium and electrolytes like potassium also has adequate amount of protein. The cereals parboiled (red rice) supply essential carbohydrate and vitamins to the baby. The table salt added for taste also provides the sodium required for baby to prevent hypernatremia The enriched, nutritious and homemade Risoy feed was found to be very effective in controlling diarrhea and there by corrected dehydration and whole some, economical easily digestible, tastes good and can be prepared in the form of porridge or conjee and can also feed with spoon or paladai. The mother were also found to be very satisfied in using this. The mother were also taught to prepare the feed. Since the preparation was done in a certified lab with the food analyses for proximity it was very safe to use for the children with secondary Lactose intolerance. Diarrhea, Malnutrition, and infection are in a cyclic manner one follows another. Every diarrhea can be managed effectively with ideal rehydration and proper monitoring of the children thereby reduce the mortality and morbidity of children due to diarrhea.
| Item Type: | Thesis (Doctoral) |
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| Additional Information: | 09089/2010 |
| Uncontrolled Keywords: | Secondary Lactose Intolerance, Lactose Free Feeds, Diarrhea, Dehydration, Children. |
| Subjects: | NURSING > Paediatric Nursing |
| Depositing User: | Subramani R |
| Date Deposited: | 07 Nov 2021 02:22 |
| Last Modified: | 07 Nov 2021 02:33 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/18606 |
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