Incidence of Refeeding Syndrome in Children With Failure to Thrive

Area of Science:

• Pediatrics
• Clinical Nutrition
• Internal Medicine

Background:

• Failure to thrive (FTT) is a common reason for hospitalization in children under 3 years old.
• Refeeding syndrome is a potential complication of nutritional rehabilitation in malnourished patients.
• Current guidelines for monitoring refeeding syndrome in FTT patients are not well-established.

Purpose of the Study:

• To determine the incidence of refeeding syndrome in otherwise healthy children under 3 years of age admitted for FTT.
• To evaluate the necessity of routine laboratory monitoring for electrolyte disturbances in this population.

Main Methods:

• A multicenter retrospective cohort study included 179 patients aged ≤36 months with a primary FTT diagnosis.
• Exclusion criteria included ICU admission, parenteral nutrition, prematurity, gastrostomy tube feeds, and complex chronic conditions.
• The primary outcome was laboratory evidence of refeeding syndrome; laboratory work was assessed at admission and post-admission.

Main Results:

• None of the 179 patients exhibited laboratory evidence of refeeding syndrome.
• 81% had admission lab work, and 39% had repeat lab work; 6% experienced adverse events from repeat draws.
• No significant electrolyte derangements indicative of refeeding syndrome were observed.

Conclusions:

• Routine laboratory monitoring for refeeding syndrome is not indicated in otherwise healthy, hospitalized children under 3 with FTT.
• Further research is needed to establish evidence-based guidelines for nutritional management and monitoring in this population.
• Reducing unnecessary laboratory evaluations can improve patient safety and reduce healthcare costs.