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Fibre content of enteral feeds for the older child

S Evans1, A Daly, P Davies

  • 1Dietetic Department, Birmingham Children's Hospital, Birmingham, UK. evanss21@onetel.com

Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association
|September 12, 2009
PubMed

Insights

Adding fibre to enteral feeds for children aged 7-12 years may improve gastrointestinal symptoms like constipation and abdominal pain. Most children still did not meet recommended fibre intake, suggesting higher levels are needed in pediatric enteral nutrition.

Area of Science:

  • Pediatric Nutrition
  • Gastroenterology
  • Clinical Dietetics

Background:

  • Lack of clinical data on fibre requirements in UK children.
  • Uncertainty regarding optimal fibre profile for pediatric enteral formulae.
  • Need to investigate fibre supplementation in high-energy enteral feeds for older children.

Purpose of the Study:

  • To investigate the effect of fibre supplementation on gastrointestinal function in children aged 7-12 years receiving enteral feeds.
  • To assess anthropometry, blood biochemistry, stool characteristics, tolerance, and oral dietary intake.

Main Methods:

  • Double-blind randomised crossover study involving 25 enterally tube-fed children.
  • Children received a 1.5 kcal mL(-1) formula with or without added dietary fibre (1.13 g per 100 mL) for 6 weeks each.
  • Comprehensive assessments included anthropometry, blood tests, stool characteristics, tolerance, and oral intake.

Main Results:

  • Higher median fibre intake (84% vs. 26% of recommended intake) with fibre-containing formula, yet most children remained below international recommendations.
  • Evidence of reduced constipation, laxative reliance, and abdominal pain with fibre supplementation.
  • Small feed volumes (median 800 mL day(-1)) contributed to suboptimal fibre intake.

Conclusions:

  • Fibre-containing enteral formulae should be standard practice for most children on enteral feeds due to poor intake and lack of adverse effects.
  • Current enteral formulae likely require higher fibre levels for older children.
  • Larger trials are needed to determine optimal fibre amount and blend for pediatric enteral nutrition.
Abstract

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