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Weaning infants with short bowel syndrome associated intestinal failure from parenteral nutrition: An ERNICA

Susan Hill1, Rebecca Pulvirenti2, Dominique Guimber3

  • 1Department of Gastroenterology, Great Ormond Street Hospital for Children, London WC1N 3JH, UK.

Intestinal Failure (New York, N.Y.)
|August 16, 2026
PubMed

Insights

Practices for weaning short bowel syndrome (SBS)-intestinal failure (IF) infants from parenteral nutrition (PN) varied widely among European centers. Further multicenter studies are needed to establish evidence-based guidelines for optimal infant outcomes.

Area of Science:

  • Pediatric Gastroenterology
  • Neonatology
  • Clinical Nutrition

Background:

  • Short bowel syndrome (SBS) with intestinal failure (IF) in infants necessitates parenteral nutrition (PN).
  • Weaning infants from PN is a critical step in managing SBS-IF.
  • European Reference Network for rare Inherited and Congenital Anomalies (ERNICA) facilitates collaboration among specialist centers.

Purpose of the Study:

  • To explore and compare the diverse practices of European Intestinal Rehabilitation Centres in weaning SBS-IF infants from PN.
  • To identify variations in nutritional strategies, feeding methods, and guideline utilization.

Main Methods:

  • A questionnaire was emailed to 49 ERNICA centers focusing on weaning practices for neonatal onset SBS-IF.
  • Data collected included oral/nasogastric (NG) feeding, protocol use, PN cycling criteria, dietary recommendations, teduglutide use, antibiotic strategies, and follow-up.
  • Descriptive statistical analysis was performed on responses from 35 participating centers across 15 countries.

Main Results:

  • Most centers (74.3%) used NG feeding to supplement oral intake in non-thriving infants <6 months, continuing for >6 months if needed.
  • While 63% used local/national guidelines for weaning PN, practices for PN cycling, dietary recommendations, and antibiotic use varied significantly.
  • Teduglutide was utilized in 92% of centers where approved and funded; 95% reduced PN infusion rates before discontinuation, and 88.6% monitored patients until adult care transition.

Conclusions:

  • Significant variability exists in nutritional strategies for weaning SBS-IF infants from PN, even among specialist centers employing guidelines.
  • Nasogastric tube feeding is common, but other weaning practices differ substantially.
  • Multicenter studies are essential to investigate practices associated with optimal outcomes and develop evidence-based guidelines for SBS-IF infant management.
Abstract

Keywords:
Enteral FeedingIntestinal FailureIntestinal rehabilitationNutritionShort Bowel Syndromeparenteral nutrition

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