Growth of Infants with Intestinal Failure or Feeding Intolerance Does Not Follow Standard Growth Curves

Danielle L Morton1, Keli M Hawthorne2, Carolyn E Moore3

  • 1SNG Dialysis, 1520 W. Frank St., Lufkin, TX 75904, USA.

Insights

Infants with intestinal failure or feeding intolerance experience impaired growth velocities and declining growth percentiles. Their development deviates significantly from standard growth curves during the first three months of life.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Growth and Development

Background:

  • Infants with intestinal failure or feeding intolerance are at high risk for extrauterine growth restriction.
  • Nutritional compromise significantly impacts infant development and long-term health outcomes.

Purpose of the Study:

  • To evaluate the growth velocities of infants with intestinal failure and feeding intolerance during the first three months of life.
  • To determine the growth percentiles at birth and 40-week postmenstrual age (PMA) in this vulnerable population.

Main Methods:

  • A retrospective chart review of 164 infants managed by the Texas Children's Hospital Intestinal Rehabilitation Team (April 2012 - October 2014).
  • Calculation of weekly weight, length, and head circumference growth velocities.
  • Comparison of growth data against Olsen growth curves to establish precise percentiles.

Main Results:

  • Average growth velocities for weight gain (19.97 g/d), length (0.81 cm/week), and head circumference (0.52 cm/week) at 3 months were below expected norms.
  • Growth velocities further decreased by discharge or death, except for weight gain (20.56 g/d).
  • Significant decreases in weight, length, and head circumference percentiles were observed from birth to 40-week PMA (P < 0.001).

Conclusions:

  • Infants with intestinal failure or feeding intolerance exhibit growth patterns that do not align with standard growth curves.
  • These findings highlight the critical need for specialized monitoring and interventions to support growth in this population.

Related Concept Videos

Anatomy of the Intestines01:53

Anatomy of the Intestines

Although digestion of proteins, carbohydrates, and lipids may begin in the stomach, it is completed in the intestine. The absorption of nutrients, water, and electrolytes from food and drink also occurs in the intestine. The intestines can be divided into two structurally distinct organs—the small and large intestines.Small IntestinesThe small intestine is an ~7 meter-long tube with an inner diameter of just 2.5 cm. Since most nutrients are absorbed here, the inner lining of the small intestine...
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
Enteral Nutrition I: Orogastric and Nasogastric Feeding01:26

Enteral Nutrition I: Orogastric and Nasogastric Feeding

Enteral nutrition delivers nutrients directly to the stomach or small intestine through a tube. This method is appropriate for patients who cannot eat but still have a functioning digestive system. It is also beneficial for individuals with swallowing difficulties, anorexia, malabsorption, or those who have undergone gastrointestinal (GI) surgery.
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding01:15

Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding

Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Physical Growth During Infancy and Toddlerhood01:18

Physical Growth During Infancy and Toddlerhood

Physical growth is especially rapid during the first three years of life, with the greatest rate in the first few months after birth. Although children continue to gain height and weight throughout infancy and toddlerhood, the rate of growth gradually slows during the second and third years. At most ages, boys are typically slightly taller and heavier than girls, reflecting a common pattern of early physical development.Changes in Body ProportionsAs infants become toddlers, their body...