Nutritional Feeding Strategies in Pediatric Intestinal Failure

Olieman, Joanne; Kastelijn, W

doi:10.3390/nu12010177

Cited by 22 publications

(13 citation statements)

References 109 publications

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“…To our knowledge, there is no trial aimed at verifying the best type of feeding after NEC resection. There is a large consensus reporting human milk as best choice of feeding for newborns and infants with SBS [ 44 , 156 , 158 , 159 , 160 , 161 ]. Breast milk is rich in proteins (immunoglobulin A), nucleotides, live cells, and growth factors together with other components such as lactoferrin and more than 100 different oligosaccarydes that can reinforce the immune system and enhance intestinal growth and adaptation [ 162 , 163 , 164 , 165 ].…”

Section: Best Nutrition Strategies To Enhance Intestinal Adaptatiomentioning

confidence: 99%

“…More recently, the use of cow’s preterm formula has been recommended in the absence of human milk [ 158 ], since it is characterized by higher caloric density and a composition based on lower lactose, higher MCT and long-chain triglycerides contents with the well-known advantages of these lipids [ 188 ]. The use of semi-elemental or elemental formula is suggested in those patients who are intolerant to conventional preterm/term formula [ 159 , 160 ].…”

Section: Best Nutrition Strategies To Enhance Intestinal Adaptatiomentioning

confidence: 99%

“…A practical approach could be to start with continuous feeding followed by bolus feeding, and as soon as possible introduce small volume of feeding orally administered [ 159 , 193 ] to stimulate swallow reflexes and avoid later full aversion disease [ 200 , 201 ].…”

Section: Best Nutrition Strategies To Enhance Intestinal Adaptatiomentioning

confidence: 99%

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Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection

et al. 2021

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Necrotizing enterocolitis (NEC), the first cause of short bowel syndrome (SBS) in the neonate, is a serious neonatal gastrointestinal disease with an incidence of up to 11% in preterm newborns less than 1500 g of birth weight. The rate of severe NEC requiring surgery remains high, and it is estimated between 20–50%. Newborns who develop SBS need prolonged parenteral nutrition (PN), experience nutrient deficiency, failure to thrive and are at risk of neurodevelopmental impairment. Prevention of NEC is therefore mandatory to avoid SBS and its associated morbidities. In this regard, nutritional practices seem to play a key role in early life. Individualized medical and surgical therapies, as well as intestinal rehabilitation programs, are fundamental in the achievement of enteral autonomy in infants with acquired SBS. In this descriptive review, we describe the most recent evidence on nutritional practices to prevent NEC, the available tools to early detect it, the surgical management to limit bowel resection and the best nutrition to sustain growth and intestinal function.

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Section: Best Nutrition Strategies To Enhance Intestinal Adaptatiomentioning

confidence: 99%

Section: Best Nutrition Strategies To Enhance Intestinal Adaptatiomentioning

confidence: 99%

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Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection

et al. 2021

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“…In terms of feeding strategies, probably the recommendation with the most agreement among experts is that in infants with IF, human milk is considered to be the first choice [ 1 , 13 ]—beyond the amply documented health benefits of human milk, it is hypothesized that different components of breast milk may themselves potentialize intestinal adaptation (such as glutamine, growth hormone, and epidermal growth factor), while other components (such as nucleotides, immunoglobulin A, leucocytes, immunoglobulins, and antimicrobial peptides) provide important immunological support and promote a favorable microbiome environment [ 14 ]. Fortunately, we found that breast milk was the universal first choice reported when feeds were introduced in neonates/infants’ diet.…”

Section: Discussionmentioning

confidence: 99%

International Latin American Survey on Pediatric Intestinal Failure Team

Spolidoro

Souza²,

Goldani

et al. 2021

Nutrients

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There is little data on the experience of managing pediatric Intestinal Failure (IF) in Latin America. This study aimed to identify and describe the current organization and practices of the IF teams in Latin America and the Caribbean. An online survey was sent to inquire about the existence of IF teams that managed children on home parenteral nutrition (HPN). Our questionnaire was based on a previously published European study with a similar goal. Twenty-four centers with pediatric IF teams in eight countries completed the survey, representing a total number of 316 children on HPN. The median number of children on parenteral nutrition (PN) at home per team was 5.5 (range 1–50). Teams consisted of the following members: pediatric gastroenterologist and a pediatric surgeon in all teams, dietician (95.8%), nurse (91.7%), social worker (79.2%), pharmacist (70.8%), oral therapist (62.5%), psychologist (58.3%), and physiotherapist (45.8%). The majority of the centers followed international standards of care on vascular access, parenteral and enteral nutrition, and IF medical and surgical management, but a significant percentage reported inability to monitor micronutrients, like vitamins A (37.5%), E (41.7%), B1 (66.7%), B2 (62.5%), B6 (62.5%), active B12 (58.3%); and trace elements—including zinc (29.2%), aluminum (75%), copper (37.5%), chromium (58.3%), selenium (58.3%), and manganese (58.3%). Conclusion: There is wide variation in how IF teams are structured in Latin America—while many countries have well-established Intestinal rehabilitation programs, a few do not follow international standards. Many countries did not report having an IF team managing pediatric patients on HPN.

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“…In clinical practice, SBS is divided into three phases: an acute phase, an adaptation and a recovery phase [ 17 ]. Successful bowel adaptation may lead to restoration of enteral autonomy.…”

Section: Foregut Manifestations and Their Pathophysiology In Intesmentioning

confidence: 99%

Gastroesophageal Reflux Disease and Foregut Dysmotility in Children with Intestinal Failure

Rybak

Sethuraman

Nikaki³

et al. 2020

Nutrients

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Gastrointestinal dysmotility is a common problem in a subgroup of children with intestinal failure (IF), including short bowel syndrome (SBS) and pediatric intestinal pseudo-obstruction (PIPO). It contributes significantly to the increased morbidity and decreased quality of life in this patient population. Impaired gastrointestinal (GI) motility in IF arises from either loss of GI function due to the primary disorder (e.g., neuropathic or myopathic disorder in the PIPO syndrome) and/or a critical reduction in gut mass. Abnormalities of the anatomy, enteric hormone secretion and neural supply in IF can result in rapid transit, ineffective antegrade peristalsis, delayed gastric emptying or gastroesophageal reflux. Understanding the underlying pathophysiologic mechanism(s) of the enteric dysmotility in IF helps us to plan an appropriate diagnostic workup and apply individually tailored nutritional and pharmacological management, which might ultimately lead to an overall improvement in the quality of life and increase in enteral tolerance. In this review, we have focused on the pathogenesis of GI dysmotility in children with IF, as well as the management and treatment options.

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Nutritional Feeding Strategies in Pediatric Intestinal Failure

Cited by 22 publications

References 109 publications

Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection

Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection

International Latin American Survey on Pediatric Intestinal Failure Team

Gastroesophageal Reflux Disease and Foregut Dysmotility in Children with Intestinal Failure

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