The role of soy isolate protein formula for children with lactose intolerance: evidence-based case report
General Medicine, 2024, 26(3), 55-62.
Z. Hikmah1, R. W. Basrowi2,3, T. Sundjaya3,4, D. Pratiwi3
1 Department of Child Health, Faculty of Medicine, Universitas Airlangga Dr. Soetomo General Academic Hospital – Surabaya, Indonesia
2 Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
3 Medical Scientific Affairs Department, Danone Specialized Nutrition – Jakarta, Indonesia
4 Department of Epidemiology, Faculty of Public Health, Universitas Indonesia – Jakarta, Indonesia
Abstract. Introduction. Lactase enzyme deficiency leads to undigested lactose, fermented by gut microbiota, causing symptoms of lactose intolerance: abdominal pain, bloating, flatulence, and diarrhea, varying severity. Herein, we present a case study of a 4-month-old male infant with persistent diarrhea since one month old was presented to a general practitioner. Despite previous hospitalizations, the root cause remained unknown. Initially exclusively breastfed, cow’s milk formula was introduced at one month due to perceived insufficient breast milk. This led to recurrent diarrhea, vomiting, and poor weight gain without fever. Objectives. To find out whether the use of soy isolated protein formula (SIF) as a lactose-free diet in cases of children with lactose intolerance is safe and sufficient to meet the nutritional requirements as well as that provided by cow’s milk formula. Method. The literature search was conducted through PubMed and Cochrane. The keywords used baby, child, lactose intolerance, soy, soy isolate, and soy isolate protein. The selection of articles was performed using the defined inclusion and exclusion criteria. Then, they were critically appraised using relevant criteria by the Oxford Center for Evidence-Based Medicine for systematic review and meta-analysis study. Result. Three relevant and valid articles consisting of 1 meta-analysis and two systematic reviews were included. SIF is proven to reduce the duration of diarrhea, treatment failure, and the duration of mean crying time as symptoms of colic in infants, and lactose intolerance has been postulated as a possible causative factor. The effectiveness of soy-based formula gives the same good results compared to the cow-based formula in terms of growth patterns, bone health, and metabolic, reproductive, endocrine, immune, and neurological functions. Conclusion. The current evidence shows sufficient evidence to ensure that compared to CMF, SIF had a positive effect in controlling the symptoms of lactose intolerance. SIF provides the same results in fulfilling nutrition for children’s growth and development with no negative adverse effects.
Key words: infant, children, lactose intolerance, soy formula, isolate protein
Address for correspondence: Ray Wagiu Basrowi, e-mail: ray.basrowi@gmail.com; e-mail: ray.basrowi1@danone.com