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Use of blended feeds in children requiring tube feeding
Jessica Sun1,2, Irene Chuah1, Alexandra Drobiszewski1
1General Medicine Department, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Insights
Blended tube feeding (BTF) in children, often chosen by parents for symptom control, did not show increased complications or hospital admissions. However, this pediatric feeding method did not promote weight gain in underweight children.
Area of Science:
- Pediatric Nutrition
- Gastroenterology
- Clinical Pediatrics
Background:
- Blended tube feeding (BTF) is controversial in pediatric care due to concerns about nutritional adequacy, infection risks, and equipment issues.
- Australian parents are increasingly opting for BTF for their children, even when it contradicts hospital guidelines, highlighting a need for more research.
Purpose of the Study:
- To characterize the pediatric population using blended tube feeding (BTF) electively.
- To evaluate the clinical outcomes associated with BTF in children with complex medical conditions.
Main Methods:
- A retrospective case-series study was conducted at a tertiary pediatric hospital.
- Demographic, anthropometric, and clinical data were collected from 178 clinical visits of 26 participants.
Main Results:
- BTF was most frequently used for symptom control (30.8%) in children with a median age of 4.1 years.
- Respiratory conditions were the most common reason for clinical presentation (47.2%).
- No increase in hospital presentations, gastrointestinal infections, or equipment complications was observed; however, BTF did not promote weight gain, especially in underweight children.
Conclusions:
- Parental preference and symptom management drive the use of BTF in pediatric patients with complex medical needs requiring enteral nutrition.
- Blended tube feeding (BTF) in this cohort was not associated with increased complications or hospital admissions.
- The study did not find evidence of weight gain benefits from BTF in the pediatric population studied.
Aim:
The use of blended tube feeding (BTF) in children is a controversial area with persistent concerns regarding the nutritional adequacy and risk of associated infections and equipment complications. Parents in Australia are electing to use BTF in their children despite local hospital guidelines, calling for further research to support its use.
Methods:
A retrospective case-series study was conducted at a tertiary paediatric hospital, to characterise the paediatric population electively using BTF and evaluate their clinical outcomes. Demographic, anthropometric and clinical data were collected from pre-existing medical records.
Results:
Data from 178 clinical visits of 26 participants were included in analysis. The median age of participants was 4.1 years (range 7 months -14 years). BTF was most commonly used for symptom control (n = 8, 30.8%). The most common cause of clinical presentation during the use of BTF was respiratory conditions (number of presentations = 60, 47.2%). There was no reported increase in hospital presentations, gastrointestinal infections or equipment complications with the use of BTF. BTF did not promote weight gain in this population of children, particularly those who were already underweight.
Conclusion:
This case-series found the use of BTF in a paediatric population with underlying complex medical conditions requiring enteral nutrition was driven by parental preference and the goals of symptomatic control. BTF did not demonstrate benefits of weight gain, though it was not associated with an increase in complications and hospital admission.
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