Chris Smith1, Helen McCabe2, Sarah Macdonald3, Lara Morrison4, Ruth Prigg5, Sarah Trace6, Jennifer Livingstone7, Julia Callan8, Jacqui Cotton9, Gary Hubbard10, Rebecca J Stratton11. 1. Royal Alexandra Children's Hospital, Eastern Road, Brighton BN2 5BE, UK. Electronic address: chris.smith@bsuh.nhs.uk. 2. The Great North Children's Hospital, Victoria Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK. Electronic address: helen.mccabe@nuth.nhs.uk. 3. Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK. Electronic address: sarah.macdonald@gosh.nhs.uk. 4. Nottingham Children's Hospital, Queen's Medical Centre, Derby Rd, Nottingham NG7 2UH, UK. Electronic address: lara.morrison@nuh.nhs.uk. 5. Nottingham Children's Hospital, Queen's Medical Centre, Derby Rd, Nottingham NG7 2UH, UK. Electronic address: ruth.prigg@nuh.nhs.uk. 6. Bristol Royal Hospital for Children NHS Foundation Trust, Paul O'Gorman Building, Upper Maudlin St, Bristol BS2 8BJ, UK. Electronic address: sarah.trace@uhbristol.nhs.uk. 7. Royal Hospital for Sick Children, 9 Sciennes Rd, Edinburgh EH9 1LF, UK. Electronic address: jennifer.livingstone@nhslothian.scot.nhs.uk. 8. Cambridge University Hospital NHS Foundation Trust, Hills Rd, Cambridge CB2 0QQ, UK. Electronic address: julia.callan@addenbrookes.nhs.uk. 9. Jacqui R Cotton Ltd., Wiltshire SN13 8JZ, UK. Electronic address: jacqui.r.cotton@gmail.com. 10. Medical Affairs, Nutricia Ltd., Newmarket Ave, Trowbridge BA14 0XQ, UK. Electronic address: gary.hubbard@nutricia.com. 11. Medical Affairs, Nutricia Ltd., Newmarket Ave, Trowbridge BA14 0XQ, UK; Faculty of Medicine, University of Southampton, Tremona Rd, Southampton SO16 6YD, UK. Electronic address: rebecca.stratton@nutricia.com.
Abstract
BACKGROUND & AIMS: Infants with complex medical conditions often display faltering growth due to elevated nutritional requirements, poor intake and intolerance of feeding with malabsorption and maldigestion. As a result their nutritional management can be extremely challenging and enteral nutritional support is required. This study aimed to investigate the effectiveness, tolerance and acceptability of nutritional support with a specially formulated, paediatric peptide feed in infants with complex disease and signs of growth faltering with their current nutritional management. METHODS: This prospective intervention study investigated gastrointestinal (GI) tolerance, nutritional intake and compliance with feeding, anthropometry and growth in 18 infants (mean age 6.11 months ± 4.69, mean weight 4.97 kg ± 1.71) during 28 days of enteral nutritional support with a paediatric (1 kcal/ml) readymade peptide feed. RESULTS: GI tolerance to nutritional support with a peptide enteral feed was good and either improved or remained stable over the study. Compliance was excellent (94.0% ± 12.6), total energy intake improved (+23 ± 42 kcal/kg, p = 0.037) and mean weight (0.61 kg ± 0.31, p = 0.0001), length (1.89 ± 1.77 cm, p = 0.0001), head circumference (1.33 ± 1.29 cm, p = 0.001), weight for length Z score (p < 0.05), and weight for age Z score (p < 0.05) significantly improved. Sixty one percent (n = 11) of the infants showed signs of increased growth velocity, moving upwards in terms of their centiles. All 18 infants continued with the paediatric, peptide enteral feed once the study was complete. CONCLUSIONS: This prospective study showed that nutrition support with a specially formulated, paediatric peptide readymade feed was well tolerated, helped to promote growth, and can be considered suitable for use in infants with complex disease and faltering growth who are unable to tolerate a whole protein feed.
BACKGROUND & AIMS:Infants with complex medical conditions often display faltering growth due to elevated nutritional requirements, poor intake and intolerance of feeding with malabsorption and maldigestion. As a result their nutritional management can be extremely challenging and enteral nutritional support is required. This study aimed to investigate the effectiveness, tolerance and acceptability of nutritional support with a specially formulated, paediatric peptide feed in infants with complex disease and signs of growth faltering with their current nutritional management. METHODS: This prospective intervention study investigated gastrointestinal (GI) tolerance, nutritional intake and compliance with feeding, anthropometry and growth in 18 infants (mean age 6.11 months ± 4.69, mean weight 4.97 kg ± 1.71) during 28 days of enteral nutritional support with a paediatric (1 kcal/ml) readymade peptide feed. RESULTS:GI tolerance to nutritional support with a peptide enteral feed was good and either improved or remained stable over the study. Compliance was excellent (94.0% ± 12.6), total energy intake improved (+23 ± 42 kcal/kg, p = 0.037) and mean weight (0.61 kg ± 0.31, p = 0.0001), length (1.89 ± 1.77 cm, p = 0.0001), head circumference (1.33 ± 1.29 cm, p = 0.001), weight for length Z score (p < 0.05), and weight for age Z score (p < 0.05) significantly improved. Sixty one percent (n = 11) of the infants showed signs of increased growth velocity, moving upwards in terms of their centiles. All 18 infants continued with the paediatric, peptide enteral feed once the study was complete. CONCLUSIONS: This prospective study showed that nutrition support with a specially formulated, paediatric peptide readymade feed was well tolerated, helped to promote growth, and can be considered suitable for use in infants with complex disease and faltering growth who are unable to tolerate a whole protein feed.