Next Article in Journal / Special Issue
Enhancing Pediatric Palliative Care for Latino Children and Their Families: A Review of the Literature and Recommendations for Research and Practice in the United States
Previous Article in Journal
Smoothed Body Composition Percentiles Curves for Mexican Children Aged 6 to 12 Years
Previous Article in Special Issue
Risk and Resilience Factors Related to Parental Bereavement Following the Death of a Child with a Life-Limiting Condition
Article Menu
Issue 1 (January) cover image

Export Article

Open AccessReview
Children 2018, 5(1), 1; https://doi.org/10.3390/children5010001

Feeding Intolerance in Children with Severe Impairment of the Central Nervous System: Strategies for Treatment and Prevention

1
Boston Children’s Hospital, Division of General Pediatrics, Harvard School of Medicine, 300 Longwood Ave, Boston, MA 02115, USA
2
Seven Hills Pediatric Center, 22 Hillside, Groton, MA 01450, USA
Received: 1 December 2017 / Revised: 21 December 2017 / Accepted: 21 December 2017 / Published: 22 December 2017
(This article belongs to the Special Issue Pediatric Palliative Care)
Full-Text   |   PDF [194 KB, uploaded 22 December 2017]

Abstract

Children with severe impairment of the central nervous system (CNS) experience gastrointestinal (GI) symptoms at a high rate and severity, including retching, vomiting, GI tract pain, and feeding intolerance. Commonly recognized sources of symptoms include constipation and gastroesophageal reflux disease. There is growing awareness of sources due to the impaired nervous system, including visceral hyperalgesia due to sensitization of sensory neurons in the enteric nervous system and central neuropathic pain due to alterations in the thalamus. Challenging the management of these symptoms is the lack of tests to confirm alterations in the nervous system as a cause of symptom generation, requiring empirical trials directed at such sources. It is also common to have multiple reasons for the observed symptoms, further challenging management. Recurrent emesis and GI tract pain can often be improved, though in some not completely eliminated. In some, this can progress to intractable feeding intolerance. This comprehensive review provides an evidence-based approach to care, a framework for recurrent symptoms, and language strategies when symptoms remain intractable to available interventions. This summary is intended to balance optimal management with a sensitive palliative care approach to persistent GI symptoms in children with severe impairment of the CNS. View Full-Text
Keywords: pediatric; neurological impairment; feeding intolerance; retching; visceral hyperalgesia; central neuropathic pain; autonomic dysfunction; disability; pediatric palliative care; symptom management pediatric; neurological impairment; feeding intolerance; retching; visceral hyperalgesia; central neuropathic pain; autonomic dysfunction; disability; pediatric palliative care; symptom management
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Hauer, J. Feeding Intolerance in Children with Severe Impairment of the Central Nervous System: Strategies for Treatment and Prevention. Children 2018, 5, 1.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Children EISSN 2227-9067 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top