Parental Nutrition in Pediatric Oncology: A Retrospective Study From New Zealand's Largest Tertiary Cancer Center

Children with cancer frequently experience gastrointestinal symptoms such as mucositis, nausea, vomiting, and feed intolerance, impairing nutritional intake and often necessitating parenteral nutrition (PN). However, standardized criteria guiding PN initiation in pediatric oncology remain poorly defined. This study examined PN use in pediatric oncology patients, identifying key indications, patterns, and clinical considerations. A retrospective cohort study was conducted on pediatric oncology patients who received PN at a tertiary cancer center in New Zealand between June 2018 and December 2021. Data on demographics, diagnosis, nutritional status, PN indications, duration, concurrent enteral nutrition (EN), and clinical outcomes were analyzed using descriptive statistics. PN was prescribed in 108 episodes for 62 children (mean age: 7.3 y). The primary indication was mucositis (59%), followed by neutropenic enteritis (19%). PN duration was longer in hematologic malignancies than in solid tumors ( P =0.014). Malnutrition was present in 44% of patients at PN initiation. Using hospital guidelines, 77% trialed EN before PN, and EN duration before PN was deemed adequate in 62%. Concurrent EN was more common in nonhematologic (98%) than hematologic diagnoses (93%; P =0.003). PN remains essential in pediatric oncology, particularly for patients with severe mucositis. Clearer PN initiation criteria are needed to minimize overuse and associated risks.