The Effect Of Bovine Colostrum/Egg Supplementation Compared With Corn/Soy Flour In Young Malawian Children: A Randomized, Controlled Clinical Trial

Background: Bovine colostrum with egg powder (BC/egg) is rich in essential amino acids and immunoactive compounds.Objectives: This trial tested the hypothesis that a daily supplement of BC/egg would reduce linear growth faltering and environmental enteric dysfunction (EED) in Malawian infants when compared with an isoenergetic ration of corn/soy flour used as a control. EED was defined by a lactulose permeability test.Methods: This was a prospective, randomized, blinded, placebocontrolled clinical trial in which 9-mo-old infants received BC/egg or a control for 3 mo. The primary outcomes were change in length-for-age z-score (ALAZ) and urinary lactulose excretion (%L) at 12-mo-old. Secondary outcomes included episodes of diarrhea, stunting. EED, and the 16S configuration of the fecal microbiota.Results: Of the 277 children enrolled, 267 completed the intervention phase of the study. LAZ decreased in all children from 9 to 17 mo. although Delta LAZ was less in children receiving BC/egg from 9 to 12 mo (difference = 0.12 z-scores; P = 0.0011). This difference persisted after feeding was completed, with less ALAZ (difference = 0.09 z-scores). A lower prevalence of stunting was seen in the intervention group (n = 47/137) than the control group (n = 62/127) at 17 mo (RR = 0.70; 95% CI: 0.52, 0.94).The median %L at 12 mo of age in the children receiving BC/egg was 0.14%. compared with 0.17% in the control group (P = 0.74). In children with %L >0.45% at enrollment (severe EED), the BC/egg group had more children with normal %L at 12 mo of age (10/20. 50%) than was seen in controls (2/15. 13%; P = 0.024). Episodes of diarrhea and beta-diversity of the 16S configuration of fecal microbiota did not differ between the 2 groups.Conclusions: Addition of BC/egg to complementary feeding in Malawian infants resulted in less linear growth faltering.