Journal of Clinical Nutrition & Dietetics

Meeting Nutritional Needs of the Enterally Fed Child with Neurological Impairment

Introduction: Children with developmental delay and neurological impairment (NI) frequently have gastrointestinal disorders that interfere with oral food intake. For children, enteral tube feedings (EN) are sometimes used. Some parents of tube-fed children seek to provide foods, via feeding tube, they believe are more healthful.

Objective: Primary objective assessed meeting daily calorie goals; secondary objectives assessed meeting protein-intake, formula intolerance, and quantifying adverse events.

Design: A prospective, observational study enrolled children requiring EN. Participants (N=21, 1-13 years) had enteral access via gastrostomy tube; were tolerant of their pre-study EN; and received ≥90% of nutritional needs via EN. Study formula (SF), 1.0 kcal/mL, provided 15%, 51% and 34% of calories from protein, carbohydrate and fat, respectively, and contained ingredients from foods such as tomatoes, peas, green beans, peaches, chicken, and cranberry juice. Children received SF for 7 days.

Results: On average, 60% (n=12) of children met at least 90% of calorie goals, and 90% (n=18) met at least 70% of calorie goals, and 90% (n=18) met daily protein goals. All continued EN during entire study interval. Of 160 total feeding days, only 5 days reported adverse events, which were determined by a physician as unrelated or unlikely-related to SF.

Conclusion: The commercially-made, food-based formula tested was a safe, convenient, and nutritionally-balanced enteral feeding for children with NI and associated feeding disorders. Calorie and protein goals were achieved without notable intolerance and no reports of serious adverse events. The SF is a practical, nutritionally-complete, real-food option for enteral feedings in children with NI.

Author(s):

Gerard Minor, Shinobu Yamamoto, Pamela Cekola, Sarah S Cohen, Maureen B Huhmann and Krysmaru Araujo Torres

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