229 A Randomized Placebo Controlled Trial of Bovine Colostrum Fed to Children with Short Bowel Syndrome Evaluated by Metabolic Balance Studies

Background and aims Parenteral support is indicated in short bowl syndrome (SBS) patients with intestinal failure to avoid metabolic imbalance, electrolyte and nutrient deficiencies, and to maintain adequate growth and function. Length, function and adaptation of residual bowel, promoted by e.g. luminal stimulation by nutrients determine the subsequent form of therapy. Colostrum contains putative stimulatory factors why, we hypothesise that supplementation could promote adaptation in children with SBS. Intestinal absorption of energy and wet weight was used to assess efficacy of colostrum and to define intestinal failure. Methods and materials Nine children with SBS were included in a double-blinded randomised cross-over trial. Twenty percent of their enteral nutrition was replaced with bovine colostrum and a milk-mixture for 4 weeks, separated by a 4 week wash-out period. Between baseline and end of study, children were clinical and biological assessed 4 times. Results Four HPN-patients had mean energy absorption of basal metabolic rate (BMR) of 81% and wet weight absorption of basal fluid need (BFN) of 6% at baseline compared to 5 non-HPN-patients with mean energy absorption of BMR of 196% and wet weight absorption of BFN at 76%, p=0.02, p=0.05. Colostrum did not improved energy or wet weight absorption compared to milk-mix, p=0.85, p=0.59. Urea increased during colostrum supplementation, p=0.04. Conclusion The degree of intestinal function and a distinction between intestinal insufficiency and failure can successfully be assessed by energy and wet weight balance studies. Bovine colostrum did not promote intestinal adaptation.