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Safety of decanted enteral formula hung for 12 hours in a pediatric setting

Beth Lyman1, Sarah Gebhards, Cindy Hensley

  • 1Children's Mercy Hospital, 2401 Gillham Rd, Kansas City, MO 64108, USA. blyman@cmh.edu

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|July 22, 2011
PubMed

Insights

Pediatric enteral nutrition using decanted formula showed low bacterial contamination rates when recommended handling practices were followed. This study found 5% of cultures positive for coliforms, with no clinical signs of infection in patients.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Disease Control
  • Clinical Nutrition

Background:

  • Enteral nutrition is a long-standing pediatric care method, but early studies noted high bacterial contamination in formulas.
  • Safety standards for formula administration are not consistently followed, with increased manipulation linked to contamination.
  • Evidence suggests adherence to recommended practices may mitigate bacterial contamination risks in pediatric enteral feeding.

Purpose of the Study:

  • To evaluate bacterial contamination rates in decanted enteral formula administered continuously over 12 hours in pediatric patients.
  • To assess the safety and efficacy of current practice recommendations for enteral formula administration.
  • To determine the incidence of bacterial growth and clinical signs of infection in pediatric patients receiving continuous enteral feedings.

Main Methods:

  • A prospective, descriptive study involving 30 pediatric patients receiving continuous enteral feedings.
  • Formula was decanted and administered over a minimum hang time of 12 hours, following current practice recommendations.
  • Bacterial cultures were obtained from feeding tubes at baseline and every 4 hours for up to 12 hours.

Main Results:

  • Out of 111 usable cultures from 30 pediatric patients, 100 (90%) showed no bacterial growth.
  • Six cultures (5.4%) exhibited growth below the FDA contamination threshold, and 5 cultures (4.5%) from 2 patients were positive for coliforms.
  • No patients displayed clinical signs of bacterial gastroenteritis (fever, increased stool output, or deterioration) during the study period.

Conclusions:

  • Decanted enteral formula administered continuously over 12 hours demonstrated a lower-than-expected rate of bacterial growth.
  • Adherence to recommended handling practices in a pediatric hospital setting appears effective in minimizing bacterial contamination.
  • The study supports the safety of current enteral feeding protocols when implemented correctly, with minimal clinical impact observed.
Abstract

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