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Journal of Parenteral and Enteral Nutrition
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Pediatric Enteral Nutrition

David Axelrod, MD, MBA, Kimberly Kazmerski, MS, RD, CSP and Kishore Iyer, MBBS, FRCS Eng, FACS

From the Intestinal Rehabilitation and Transplantation Program, Division of Transplant Surgery, Children's Memorial Hospital, Chicago, Illinois

Correspondence: Kishore R. Iyer, MBBS, FRCS (Eng), FACS, Intestinal Rehabilitation and Transplantation Program, Children's Memorial Hospital, 2300 Children's Plaza, Box 57, Chicago, IL 60614. Electronic mail may be sent to kiyer{at}childrensmemorial.org.

Common to all pediatric patients receiving enteral nutrition is the inability to consume calories orally. This is often secondary to issues of inadequate weight gain, inadequate growth, prolonged feeding times, weight loss, a decrease in weight/age or weight/height ratios, or a persistent triceps skinfold thickness <5% for age. Enteral nutrition requires enteral access. In the neonatal period the nasoenteric route is usually used. In pediatric patients requiring long-term enteral access, surgically, endoscopically, or radiologically placed percutaneous feeding tubes are common. Jejunal feeding tubes are used in pediatric patients with gastric feeding intolerance or persistent gastroesophageal reflux. Low-profile enteral access devices are preferred by most pediatric patients because of their cosmetic appearance. For most children, a standard pediatric polypeptide enteral formula is well tolerated. There are specialized pediatric enteral formulas available for patients with decreased intestinal length, altered intestinal absorptive capacity, or altered pancreatic function. Weaning patients from tube feeding to oral nutrition is the ultimate nutrition goal. A multidisciplinary approach to patients with short bowel syndrome will maximize the use of enteral nutrition while preserving parenteral nutrition for patients with true enteral nutrition therapy failure.

Journal of Parenteral and Enteral Nutrition, Vol. 30, No. 1 suppl, S21-S26 (2006)
DOI: 10.1177/01486071060300S1S21
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[Abstract] [Full Text] [PDF]