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Complementary food introduction practices in infants with intestinal failure.

Anita M Nucci1, Kate Samela2, Elizabeth Bobo3

  • 1Department of Nutrition, Georgia State University, Atlanta, Georgia, USA.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|June 28, 2022
PubMed
Summary

Practices for introducing complementary foods (CFs) to infants with intestinal failure (IF) vary. Most RDNs introduce CFs between 4-6 months, often pureed, with specific food recommendations to minimize stool output.

Keywords:
food intakeinfantintestinal failurepediatricssurvey

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Area of Science:

  • Pediatric Nutrition
  • Gastroenterology
  • Infant Feeding Practices

Background:

  • Infants with intestinal failure (IF) often have limited oral intake due to intolerance or feeding difficulties.
  • No current guidelines exist for introducing semisolid or solid complementary foods (CFs) to infants with IF.
  • Assessing CF intake and caloric contribution is challenging due to malabsorption and incomplete recording in this population.

Purpose of the Study:

  • To identify and describe current institutional approaches to introducing CFs to infants with IF.
  • To understand the practices of Registered Dietitian/Nutritionists (RDNs) in managing CF introduction for infants with IF.

Main Methods:

  • A 10-question online survey was designed by the American Society for Parenteral and Enteral Nutrition (ASPEN) Pediatric Intestinal Failure Section RDN working group.
  • The survey assessed RDN practices related to introducing CFs to infants with IF.
  • Twenty-six RDNs completed the survey.

Main Results:

  • Fifty percent of RDNs recommend introducing CFs between 4 and 6 months of age.
  • Seventy-six percent recommend adding pureed foods to gastrostomy tube feedings.
  • Specific food recommendations to minimize stool output include green beans, bananas, infant cereals, and meats/protein (92% of respondents).

Conclusions:

  • Institutional practices for introducing CFs to infants with IF are inconsistent.
  • Similarities were noted in first food choices and foods to avoid.
  • Evidence-based guidelines are needed to establish best practices for CF introduction in IF, aiming to reduce stool output, facilitate parenteral nutrition weaning, and achieve enteral autonomy.