Tube Feeding in Neurologically Disabled Children: Hot Topics and New Directions
Abstract
:1. Introduction
2. Materials and Methods
3. Enteral Access
3.1. Feeding Regimen
3.2. Anti-Reflux Surgery
4. Real-Food-Based Enteral Nutrition
4.1. Blenderized Tube Feeds
4.2. Real-Food-Based Enteral Formulas
5. Tube Weaning
6. Parental Decision-Making Process
Quality of Life
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Percutaneous Endoscopic Gastrostomy with Jejunal Extension |
---|
Mature gastrostomy |
>10–12-French tube |
Insertion through the gastrostomy site (with a neonatal scope) or via endoscopy (with a standard scope) |
Sedation not necessary |
Radiological position confirmation not necessary |
Indications for Nissen Fundoplication |
---|
Failure of optimal pharmacological treatment |
Dependency on long-term pharmacological treatment |
Nonadherence to drugs |
Life-threatening complications of GERD (i.e., respiratory complications) |
Advantages | Disadvantages |
---|---|
Tailored to individual nutritional and micronutrient needs | Nonsterile (home temperature over a night-time continuous feeding) |
More natural (exposure to real foods and tastes) | Microbial contamination |
Compliance with dietary restrictions or preferences (dairy free, vegetarian, etc.) | Viscosity (tube obstruction) |
Improvement of feeding outcomes | Risk of error |
Likely improvement in gastrointestinal symptoms such as reflux symptoms, bloating, and constipation | Macro- and micronutrient deficiencies |
Promotion of family inclusion and mealtime engagement | Time-consuming |
Potential cost savings | Close monitoring of families |
Easier transition to tube weaning | Need of registered dietician |
Eligibility Criteria for Tube Weaning 1 |
---|
Stable underlying chronic disease |
Absence of short- or medium-term scheduled procedures that could cause or raise the risk of malnutrition (i.e., surgery and organ transplantation) |
Satisfactory or at least stable nutritional status according to standard or disease-specific growth charts |
Safe and functional swallowing |
Family willingness and availability |
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Dipasquale, V.; Aumar, M.; Ley, D.; Antoine, M.; Romano, C.; Gottrand, F. Tube Feeding in Neurologically Disabled Children: Hot Topics and New Directions. Nutrients 2022, 14, 3831. https://doi.org/10.3390/nu14183831
Dipasquale V, Aumar M, Ley D, Antoine M, Romano C, Gottrand F. Tube Feeding in Neurologically Disabled Children: Hot Topics and New Directions. Nutrients. 2022; 14(18):3831. https://doi.org/10.3390/nu14183831
Chicago/Turabian StyleDipasquale, Valeria, Madeleine Aumar, Delphine Ley, Matthieu Antoine, Claudio Romano, and Frédéric Gottrand. 2022. "Tube Feeding in Neurologically Disabled Children: Hot Topics and New Directions" Nutrients 14, no. 18: 3831. https://doi.org/10.3390/nu14183831