Enteral Nutrition

Learn practical strategies for supporting patients transitioning to home-made blended diets alongside tube feeding. The speaker explores the latest data on food-derived ingredients in adults and offer in-depth discussions, plus a Q&A session. More information on Compleat 1.1 Compleat® 1.1 | Nestlé Health Science

Learn about how to support patients through the home-made blended diet journey alongside a tube feed with food-derived ingredients and new data in adults using food-derived ingredients. To know and download the poster please follow this link Study to evaluate the gastrointestinal tolerance | N+ Hub. for more information on the product Compleat® 1.5 HP for professionals | Nestlé Health Science.

New Directions in Home Enteral Feeding: Are food-derived ingredients changing the landscape? Expert dietitians share their views in a recorded roundtable discussion. Join us as we watch back Episode 1, the first instalment in a 3-part series of short lunchtime webinars where home enteral feeding dietitians discuss their current practice and challenges as well as the clinical evidence for food derived ingredients in enteral nutrition formulas and where they see their use changing dietetic practice and expanding options for patients. You can watch episode 2 here. And episode 3 here. Chairperson: Stephanie Wakefield, Specialist Upper GI Dietitian and Lecturer in Human Nutrition & Dietetics, Newcastle Upon Tyne Hospitals, Newcastle University Speakers: Adrian Gilson, Band 7 Community Nutrition Support Dietitian Jamie Leung, Lewisham Healthcare NHS Trust, Department of Paediatrics Karen Voas-Wootton, Glan Clwyd Hospital, Adult Team Lead Kirsty Capper, Chester Adult Community, Adult Team Lead Hannah Meanwell, Nottingham Hospital, Adult HEF Dietitian

New Directions in Home Enteral Feeding: Are food-derived ingredients changing the landscape? Expert dietitians share their views in a recorded roundtable discussion. Join us as we watch back Episode 2, the second instalment in a 3-part series of short lunchtime webinars where home enteral feeding dietitians discuss their current practice and challenges as well as the clinical evidence for food derived ingredients in enteral nutrition formulas and where they see their use changing dietetic practice and expanding options for patients. You can watch episode 1 here. And episode 3 here. Chairperson: Stephanie Wakefield, Specialist Upper GI Dietitian and Lecturer in Human Nutrition & Dietetics, Newcastle Upon Tyne Hospitals, Newcastle University Speakers: Adrian Gilson, Band 7 Community Nutrition Support Dietitian Jamie Leung, Lewisham Healthcare NHS Trust, Department of Paediatrics Karen Voas-Wootton, Glan Clwyd Hospital, Adult Team Lead Kirsty Capper, Chester Adult Community, Adult Team Lead Hannah Meanwell, Nottingham Hospital, Adult HEF Dietitian

New Directions in Home Enteral Feeding: Are food-derived ingredients changing the landscape? Expert dietitians share their views in a recorded roundtable discussion. Join us as we watch back Episode 3, the third and final instalment in a 3-part series of short lunchtime webinars where home enteral feeding dietitians discuss their current practice and challenges as well as the clinical evidence for food derived ingredients in enteral nutrition formulas and where they see their use changing dietetic practice and expanding options for patients. You can watch episode 1 here. And episode 2 here. Chairperson: Stephanie Wakefield, Specialist Upper GI Dietitian and Lecturer in Human Nutrition & Dietetics, Newcastle Upon Tyne Hospitals, Newcastle University Speakers: Adrian Gilson, Band 7 Community Nutrition Support Dietitian Jamie Leung, Lewisham Healthcare NHS Trust, Department of Paediatrics Karen Voas-Wootton, Glan Clwyd Hospital, Adult Team Lead Kirsty Capper, Chester Adult Community, Adult Team Lead Hannah Meanwell, Nottingham Hospital, Adult HEF Dietitian

This is the second episode of “Elevate Your Practice” series with Adrian Gilson. He goes through how to overcome recent challenges with patients’ caseload and improve DNA rates with practical tips on daily activities.

A Retrospective Study Join the discussion on this retrospective study results and get more in-depth data on the outcome measures. INFORMATION FOR HEALTHCARE PROFESSIONAL USE ONLY. Compleat paediatric is a food for special medical purposes for use under medical supervision.

Join Resilience Coach Mike Andrews as he discusses the importance of resilience when navigating the workplace environment. Receive practical tips on how to build your own resilience and elevate your practice. Register now and secure your place.

This webinar was first shown on Wednesday 27th March 2024. Join us for an exclusive insight into the world of Blended Diet Networks! Charlotte Cole, highly specialised Adult Specialist Neurology Dietitian and speaker at the recent Blended Diet Network Event, shares her expert views on Blended Diets in adult care and the evolving landscape of dietetic practice in this field. Hazel Duncan, Specialist Paediatric Dietitian, sheds light on the critical role of staying informed about evolving dietetic practices and the power of networking within the field to enhance care for tube-fed patients. Kate Grimshaw, Specialist Allergy Dietitian, discusses the shifting perspective on blended diets and forecasts their expanded usage as paediatric patients transition into adulthood. To watch the talks from the Blended Diet Network Event in full, please visit the Blended Diet Network Annual Event 2023 page.

Third Session: Q&A session with Rita Shergill-Bonner & Dr Graeme O’Connor The webinar was live in February 2024. The speakers discussed the Real-World Evidence for children with neuro-disabilities who have low energy expenditure coupled with feed intolerances may benefit from a low-energy hydrolysed enteral formula to minimise the risk of excessive weight gain, further compromising mobility and obesogenic complications.

Second Session: “Impact of a partially hydrolysed low energy enteral formula in children with a neurological impairment gastrointestinal.” with Dr Graeme O’Connor Ph.D. RD MBDA, Research lead for Dietetics at Great Ormond Street Hospital The webinar was live in February 2024. The speakers discussed the Real-World Evidence for children with neuro-disabilities who have low energy expenditure coupled with feed intolerances may benefit from a low-energy hydrolysed enteral formula to minimise the risk of excessive weight gain, further compromising mobility and obesogenic complications.

First Session: Gastrointestinal implications of neurological impairment” with Rita Shergill-Bonner, RD, Lead Gastroenterology Paediatric Dietitian at Evelina London Children’s Hospital The webinar was live in February 2024. The speakers discussed the Real-World Evidence for children with neuro-disabilities who have low energy expenditure coupled with feed intolerances may benefit from a low-energy hydrolysed enteral formula to minimise the risk of excessive weight gain, further compromising mobility and obesogenic complications.

Join the Expert Speaker who will discuss different approaches to Nutrition Management. The speakers will be discussing the impact of clinical decisions related to the nutritional care of patients, in terms of improving outcomes.

Registered Dietitian, Grace Shelley, provides an overview of the current guidelines for the nutritional management of children with Cerebral Palsy and reflects on a case study where she recommended a tube feed with food-derived ingredients for one of her patients.

Although healthcare professionals continue to seek the most appropriate and effective enteral feeding modes for their patients, there is an ongoing debate between the effectiveness of intermittent bolus and continuous feeding. Join Dr O’Connor and Lyvonne Tume as they dive into this debate, exploring current definitions of feed intolerance and research evidence, particularly the GASTRIC study, for which Lyvonne is the chief investigator.

This webinar discusses indications of when to use a 1.5kcal/ml peptide based ONS feed, with a full case study presented with Jacqueline Lowdon and follow-up Q&A session. To find out more about the peptide range please click here.

This Nestlé Nutrition Institute symposium at ESPGHAN 2023 looks at new trends across enteral nutrition, specifically for children with gastrointestinal impairment. From weaning enterally fed children to improving their tolerance with food-based nutrition, hear from key speakers from across the globe.

This session is part of the webinar 'Fibre Maze – Influence on Gut Health and GI disorders'. In this session Dr. Anna Rybak & Dr Graeme O’Connor answered questions and discussed topics raised by dietitians during the event.

This session is part of the webinar 'Fibre Maze – Influence on Gut Health and GI disorders'. In this session Dr. Graeme discusses the barriers to meet nutrition requirements in an acute clinical setting plus a case study presentation.

This session is part of the webinar 'Fibre Maze – Influence on Gut Health and GI disorders'. In this session Dr. Anna discusses how fibre plays an essential role in maintaining the structure and function of the gut microbiome. Dr Anna Rybak is paediatric gastroenterologist, and she is a co-author of 50 publications, first author of 13 original publications, and a co-author of several book chapters on motility disorders and feeding disorders in children.

This webinar had the focus on the use of fibre supplements' in the nutritional management of patients with acute illness. The speaker, Nirouz Zarroug, discussed the impact of clinical decisions related to patient care.

The session is part of Blended Diet Network event held on 16th of November 2022. It contains the live discussion with Q&A for the sessions held on the same day of the event. 

The session is part of Blended Diet Network event held on 16th of November 2022. The speaker discussed the blended diet experience in Ireland.   

The session is part of Blended Diet Network event held on 16th of November 2022. The speaker discussed how to develop a Special Operating Procedure for supporting blended diet in a specialist children’s Hospital. This session is BDA CPD accredited.  

The session is part of Blended Diet Network event held on 16th of November 2022. The speaker discussed the recent trends for blended diets and displaying the evidences behind. This session is BDA CPD accredited.  

Dr Graeme O’Connor provides a short summary of the research findings of a real world evidence study involving a formula with food derived ingredients

We have seen increasing interest in using blenderized real food for enteral nutrition. How is the trend evolving, what is the impact on paediatric patients and should it be supported by healthcare professionals? Read an overview of the symposium below or watch the video by clicking the image on the left. You will need to be signed into the N+ Hub to view this.   Download summary More information on Compleat® Paediatric      

This real-world evidence study explores the results from a multi-centre retrospective study of children who have switched to a tube feed containing food-derived ingredients. Read the publication, or watch our webinar where speakers discuss the positive outcomes and the potential impact they might have on local guidelines or day to day clinical practice.

This webinar explores the management of nutritional challenges in patients across both children and adults, including transitional care. Speakers discuss the spectrum of energy requirements and the importance of meeting these, as well as tolerance issues, implementation of guidelines, time-saving tools and helpful studies.

Our free multidsciplinary tool for identifying symptoms of feeding intolerance and offering pragmatic guidance for their management. Download it today!

Kathyrn Simpson, Paediatric Dietitian, worked with 8 of her families for the acceptability and tolerance study for Peptamen Junior 1.5. Hear about Kathryn’s experience of being involved in the trial and in particular, learn about two children who took part. Case study 1 focuses on a 6 year old girl with complex TOF and OA. Case study 2 is an 8 year old girl with Cockayne Syndrome.  

Watch our panel discussion hosted by four experienced dietitians, who together explore how best to manage energy requirements amongst children with a variety of conditions, answering questions sent in by other healthcare professionals.    

'Feeding the complex needs child’ by Clinical Specialist Dietitian, Esther Wright, talks through a case study with a 3-year-old girl with holoprosencephaly.

Join us for the third webinar in the series on Emerging Trends in Blended Diet. Chaired by Kate Samela a registered dietitian with over 20 years experience and numerous publications on blended diet, this webinar has a fantastic line up of speakers including;  

Join us for an exciting webinar which will provide details of the new PENG recommendations and outline how they can be applied in clinical and acute settings as well as in community services.

This webinar dives into the emerging trend of blended diets for enteral feeding. There is some evidence to suggest that blended diets, used solely or in combination with commercially available enteral feeds, can have a number of benefits for children such as a reduction in GI symptoms or improved overall physical and developmental health.

Learn more about MCTs and their role in reducing fat malabsorption

Nestle Health Science are delighted to share with you the second webinar in its series covering ‘Emerging Trends in Blenderised Diets’. This free CPD event focuses specifically on the practical challenges that Healthcare Professionals face in supporting parents, carers and families through their journey in using blenderised diets as a source of nutrition for their child.

Barbara Davidson, Specialist Dietitian from the Freeman Hospital discusses the nutritional challenges of managing acute patients with pancreatitis.

Nirouz Zarroug, Haematology Specialist Dietitian, talks through the role of nutrition in stem cell transplants. Covering the impact of a transplant on nutrition, neutropenic diet, nutritional support options, evidence based practice in HSCT and nursing implementation.

This webinar explores what best practice looks like when it comes to optimising nutrition for children with cerebral palsy and other neurological conditions. Topics such as growth and feed tolerance will be discussed as well as special considerations for Healthcare Professionals when patient access is restricted due to Covid 19.

A multi-centre, single arm study designed to evaluate the gastro-intestinal tolerance and compliance of a standard adult enteral tube feed with food derived ingredients in the United Kingdom.

Home-made food via a feeding tube is becoming increasingly common. Adult studies have shown benefits of using a commercial formula with food-derived ingredients (FDI): significantly lower rates of constipation, nausea, and vomiting (P < 0.05)1. A prospective, multi-centre study assessed gastro-intestinal tolerance and compliance of an enteral formula with 19% of FDI (Compleat _1.5 HP Nestlé Health Science) in children and adults.

The need for discussion around the topic of Blended Diets (BD) for home enteral feeding (HEF) resulted in Nestlé Health Science organising a round table in London at the end of June. NHD’s regular columnist and contributor, Priya Tew, RD, was at the helm, chairing the talks, and panellists included our regular contributor, Hazel Duncan, RD, who has much experience in paediatric enteral feeding using BD. Download summary

The use of a PHGG supplement or a nutritionally complete formula containing PHGG as a source of soluble dietary fibre can be helpful to manage paediatric conditions associated with chronic or recurrent gastrointestinal symptoms. Claudio Romano, Socrate Pallio , Ugo Cucinotta , Paola Accorsi & Valeria Dipasquale (2021): Fibers in pediatric functional gastrointestinal disorders. Practical considerations from clinical cases, Expert Review of Gastroenterology & Hepatology. DOI: 10.1080/17474124.2021.1884543

Partially hydrolysed guar gum (PHGG) is a water-soluble fibre supporting digestive health with well-established safety and efficacy. This open-label, single-arm, multicentre trial aimed to assess the tolerability and safety of a semi-elemental enteral formula containing PHGG at 12 g/L in tube-fed young children.  Published: April 20, 2023 DOI: https://doi.org/10.1016/j.clnesp.2023.04.004 For full text: Tolerability and Safety of a Semi-elemental Enteral Formula with Partially Hydrolyzed Guar Gum (PHGG) in Tube-fed Children Aged 1-4 Years: An Open-label, Single-arm Study - Clinical Nutrition ESPEN

Background and aim: A perceived factor believed to have an impact on feed tolerance relates to the mode in which nutrition is delivered regarding intermittent bolus or continuous feeding. Enteral formulas with food derived ingredients have been developed to help address some of the many feeding issues experienced by children who are tube fed. This study aimed to evaluate the tolerance of different feeding modes in children who are fed with an enteral formula with food derived ingredients.

This Research Outreach article explores how blended diets for children with long-term feeding tubes are becoming more popular. The BDA toolkit for blended diets is now available to help support dietitians and this, along with open discussions and multi-disciplinary working, can help families plan for the best outcomes for the child. The launch of a formula feed in 2020 with food-derived ingredients may also help support some families.

View this infographic for a summary of the multi-centre retrospective real-world evidence study of children who have switched to a tube feed containing food-derived ingredients.   Order Samples About Compleat® paediatric Compleat® paediatric (formerly known as Isosource® Junior Mix) is currently the only paediatric tube feed in the UK&I that contains food-derived ingredients*. Nutritionally complete 1.2kcal/ml feed for children 1 year and over Halal certified and gluten-free Iso-osmolar (Osmolarity: 280 mOsm/l Osmolality: 340mOsm/kg) 18g protein (33% from rehydrated chicken, green peas and green beans) and 5g fibre (51% of fibre from vegetables and fruits) per 500ml bottle * Compleat® paediatric contains 13.8% food derived ingredients from rehydrated chicken, rehydrated vegetables (peas & green beans), peach puree and orange juice from concentrate. Compleat® paediatric is currently the only feed in the UK&I with food-derived ingredients.

There are some considerations to take into account when moving a child onto a new feed. This tool provides guidance on transitioning a child onto Compleat® paediatric from whole protein feeds, peptide-based formulas or extensively hydrolysed or amino acid feeds.   ORDER SAMPLES

Dr Graeme O’Connor, Research Lead for Dietietics at Great Ormond Street Children’s Hospital, explores the results from a retrospective multi-centre study in his latest article. The study monitored 43 children switching to a tube feed containing food-derived ingredients, and how it was tolerated. 

Compleat® paediatric (Nestlé Health Science) is a nutritionally complete 1.2kcal/mL ready to hang enteral tube feed. It contains ingredients derived from real food (rehydrated chicken, rehydrated vegetables (peas and green beans), peach puree and concentrated orange juice). A busy London hospital’s paediatric outpatient department agreed to take part in a prospective acceptability study of Compleat® paediatric. This resource shares the study process, outcomes and conclusion from Tara Kelly’s perspective.

This resource details a seven day trial of Compleat® paediatric. Child A had an unsafe swallow, and loose stools. The goals were to meet all nutritional requirements and encourage better stool consistency. Log in to read more about the outcome of the trial.

These guidelines were written by Marie Watson, specialist home enteral feeding dietitian in Sheffield Children’s (NHS) Foundation Trust, to provide advice in relation to the safe risk assessed process for preparation, storage, and administration of blended diet via a Gastrostomy button. Marie has given Nestlé Health Science permission to share her resource with other Healthcare Professionals following her presentation on a recent webinar ‘Emerging Trends in Blended Diets, One Year On – Evidence and Clinical Practice’. 

Due to reduced levels of physical activity in children with cerebral palsy or other neurodisabilities, there is a risk of tube-fed individuals becoming overweight or obese if their feed contains an excess of calories. Nestlé Health Science provide a nutritionally complete, lower energy formula, Peptamen® Junior 0.6, that can be used to overcome this problem. Peptamen® Junior 0.6 is a well tolerated, low-energy, peptide-based feed with fibre that has been shown to reduce gastrointestinal symptoms in children with neurological impairment.

A multi-centre, single arm study to evaluate the gastro-intestinal tolerance and compliance of a high energy adult enteral tube feed with food derived ingredients.

New Directions in Home Enteral Feeding: Are food-derived ingredients changing the landscape? Expert dietitians share their views in a recorded roundtable discussion.

The webinar was live in February 2024. The speakers discussed the Real-World Evidence for children with neuro-disabilities who have low energy expenditure coupled with feed intolerances may benefit from a low-energy hydrolysed enteral formula to minimise the risk of excessive weight gain, further compromising mobility and obesogenic complications.

The prevalence of children with complex neuro-disability has increased due to advances in the medical management of preterm infants and improved care for children with severe neurological impairment . Neuro-disability covers a wide range of clinical conditions, including acquired brain injury, epilepsy and learning disability. Neuro-disabilities present a significant disease burden for the child and family, with the focus for families to promote the best possible participation in life for all affected. Children with neuro-disabilities can be significantly disadvantaged in their ability to nourish themselves due to poor hand to mouth motor coordination, along with disordered swallowing, resulting in aspiration of food in the lungs. The length of feeding time may be considerably increased and instead of mealtimes being an enjoyable experience, they are distressing for both child and carer. These impairments in feeding eventually lead to undernutrition and invariably children require a feeding tube to ensure nutritional requirements are met. Although tube feeding improves overall nutritional status, it has also been associated with an excess deposition of body fat compared with typically developing children. Children with neuro-disability are at risk of becoming overweight because of their low activity and psychosocial constraints. Additionally, children with a neuro-disability tend to grow slowly for non-nutritional reasons and have altered body composition due to underdeveloped skeletal muscle. Children are more likely to be overweight and tend to have low lean muscle mass - therefore a low BMI in this group does not necessarily imply low fat stores. Efforts are needed to protect severely disabled children from overfeeding and to help families of children with neuro-disabilities to manage their child’s weight. Children with neuro-disabilities who are fed to 80% of their estimated average energy requirements have reported a positive energy balance resulting in high body fat mass. Of note, any attempt to dilute the existing proprietary feeds to reduce the calorie intake to a level commensurate with the energy expenditure of a child with a disability is likely to have an adverse impact on micronutrient and protein intake. The clinical nutrition industry has responded to this need and developed commercially available enteral formulas that are low in energy but nutritionally adequate for protein and micronutrients, essential for developing children who are reliant on enteral formula to supply a major proportion of their intake [8]. Additionally, feed tolerance is generally worse in children with neuro-disabilities, associated with comorbidities including epilepsy, posture and tone disorders, and medications used for the treatment of these conditions can further exacerbate gastrointestinal function. Common feed related symptoms associated with neuro-disabilities include vomiting, retching, pain associated with feeding - feedinduced dystonia, constipation, and gastrointestinal dysmotility. The aim of this national multicentre retrospective study was to monitor the effectiveness of a low energy hydrolysed enteral formula on weight management, feed tolerance and health economics in children with a neuro-disability.

A hub of tube feeding support and guidance for parents & carers of tube fed children. Talking Tube Feeding features informative articles written by healthcare professionals, inspiring stories shared by tube feeding families, and even blended diet recipes created by a dietitian. Share with your families today! All Talking Tube Feeding articles and videos have been created in partnership with healthcare professionals and tube feeding families, aiming to offer credible tube feeding information. Visit Now Highlights include   Andie & Ava's Story - 3 part video series 10+ Blended Diet recipes written by a paediatric dietitian Tube feeding glossary & equipment guide Transitioning to adult care Share with your patients' families today! www.talkingtubefeeding.com Contribute to Talking Tube Feeding We’re always looking for healthcare professionals to contribute their expertise to the Talking Tube Feeding website. So, if you have an interesting topic suggestion, get in touch at: talkingtubefeeding@uk.nestle.com Connecting with Families If you think your families would like to share their tube feeding experiences on Talking Tube Feeding, please contact us on: talkingtubefeeding@uk.nestle.com. We can work flexibly with families, whether they want to contribute quotes/recommendations or a full diary-style feature. To order Talking Tube Feeding pens and leaflets for your families, please contact your Nestlé Health Science representative.

Dr Graeme O’Connor from Great Ormond Street Hospital, London, UK explores the use of blended tube feeds in detail, covering microbiomes and dysbiosis, tolerance and the role of short chain fatty acids, while sharing his own clinical experience of using feeds containing food-derived ingredients.

Published in HSOA Journal of Neonatology and Clinical PediatricsThis case study series provides an overview of four children aged between twenty-six months to ten years. The children have a range of conditions including learning and physical disabilities, digestive tract abnormalities and genetic conditions such as DiGeorge’s syndrome. Reflux, constipation and vomiting were among the symptoms of feed intolerance reported.  Significant improvements in these symptoms were reported following a change to Compleat Paediatric®; a 1.2 kcal/ ml formula with 14% food derived ingredients (Nestlé Health Science), which resulted in improved quality of life for children and their families. Compleat Paediatric® could be considered as a sole source of nutrition or in conjunction with BD when children are not tolerating a standard commercial formula.Case studies provided by;Aneeqa Siddiqui, Paediatric Dietitian, Birmingham Women’s and Children’s NHS FoundationTrust, Birmingham, UKVictoria Steele, Senior Specialist Dietitian, Friarage Hospital, Northallerton, UKMarti van der Linde, Community Paediatric Dietitian, Worcestershire North, Nutrition and Dietetic teamOrder Samples

Watch our webinars here: Emerging Trends in Blended Diets 1 Year on – Evidence & Clinical Practice The third webinar in the series has four experienced clinicians talk about their experiences of transitioning paediatric patients to a blended diet, as well as, a tube feeding formula with food-derived ingredients. Our speakers dive into the anatomy of why providing a blended diet may be better tolerated than a standard tube feed, as well as the process and multi-disciplinary team approach in creating and implementing a blended diet policy. Followed by an engaging Q&A with the audience. Speakers; Kate Samela, Dr Mohamed Mutalib, Marie Watson and Naheeda Habib   A Practical Implementation of Blended Diets for Healthcare Professionals The second webinar in the series, focuses specifically on the practical challenges that Healthcare Professionals face in supporting parents, carers and families through their journey in using blended diets as a source of nutrition for their child. Our speakers discuss feeding tubes, risk assessments and how they have successfully introduced blended diets to their patients. Speakers; Dr Su Bunn, Denise Kennedy, Vicki Steele and Clare Armstrong   The Emerging Trend of Blended Diets; Sharing Best Practice Amongst Healthcare Professionals Our first webinar dives into the emerging trend of blended diets for enteral feeding. Our speakers discuss how blended diets may change the way we think about tube feeding and compare with the USA, who are leading the way when it comes to blended diets and food-based formulas. We hear about the positive move made by the British Dietetic Association in their updated guidance on blended diets and hear about the growing evidence for a newly available prescribed feed that contains food-derived ingredients. Speakers; Gerard Minor, Dr Clare Thornton-Wood, Jayne Lewis      

Recently, as reported by dietetic departments in the United Kingdom, we have seen an increase in Homemade Blended Diets (HBD) being given to children requiring tube feeding. HBD practice may increase the risk of tube occlusion and nutritional inadequacies. In 2015 the British Dietetic Association (BDA) developed their first ‘Practice toolkit liquidised food via gastrostomy tube’, whic...

This checklist can be used when transitioning a child onto a blended diet, using Compleat® paediatric as a base in recipes. Use this resource as a blended diet risk assessment and agreement between parents/carers and dietitian.

Critical illness is often associated with catabolism. Consequently, providing nutritional support to those who cannot eat is essential to prevent malnutrition in the critical care setting.1 When considering nutrition support in the critical care unit (ICU), certain comorbidities should be taken into careful consideration when formulating an enteral feeding plan. For exa...

Many patients requiring long term enteral nutrition have neurological disorders, such as motor neurone disease (MND) or Huntington’s disease (HD). In our experience, a proportion of these individuals may struggle to tolerate enteral feeding despite optimising medical management and excluding obvious gastrointestinal pathology. In MND, prolonged reduced mobility, weaknes...

This case study discusses the nutritional management of a severely undernourished patient with head and neck cancer. The patient experienced diarrhoea and significant weight loss, despite the use of various enteral formulas and delivery methods (continuous and bolus feeding). Thereafter a combination of products within the Peptamen® range were trialled. A marked reduction i...

Major trauma refers to significant or multiple injuries that could result in death or severe disability, sustained from a traumatic insult such as a road traffic collision, fall, sporting accident, or physical assault. It is the leading cause of death and major disability in people aged under 45 years in the UK.1 Critically injured patients are often managed on ...

GEORGE IS A 63 YEAR OLD MARRIED MAN WHO WAS DIAGNOSED WITH MALIGNANT NEOPLASM OF THE OESOPHAGUS IN SEPTEMBER 2011. A two stage oesophago-gastrectomy was performed in February 2012 with a jejunal tube inserted for feeding. The patient reported that during his hospital stay he was given a polymeric feed via the jejunostomy. He suffered with severe diarrhoea for the length of his hospital stay. He was discharged home in April 2012, taking small meals and snacks without enteral nutrition. Over a 6 mo...

Introduction/overview Chronic pancreatitis is a progressive and irreversible inflammatory disease of the pancreas. This results in exocrine and endocrine dysfunction which in time leads to maldigestion and malabsorption reducing the body’s ability to utilise essential macro and micronutrients. Consequently protein energy malnutrition is common. Research indicates that in more than 80...

This case study discusses the nutritional management of a critically ill patient with a traumatic brain injury (TBI). Due to poor tolerance of gastric feeding, his nutritional requirements could not be met using a polymeric formula. His feed was changed to Peptamen® HN (a 100% whey peptide feed) and enteral absorption improved, allowing his full nutritional requirements to b...

Human immunodeficiency virus (HIV) is a virus that attacks the immune system specifically targeting CD4 cells, white blood cells which play a major role in protecting against infection. As the virus progresses and the CD4 count decreases there is an increased risk of certain infections referred to as ‘opportunistic infections’ (OIs). The gastrointestinal (GI) tr...

"ENTERAL TUBE FORMULA: A MULTICENTRE TRIAL IN THE UNITED KINGDOM The prevalence of Cerebral Palsy (CP) children who require a low-calorie feed is between 8-15%. ESPGHAN working group recommend using a low-fat, low-calorie, high fibre, micronutrient replete formula for immobile Neurological Impaired children. Children aged 1-11 years with neurological issues were recruited from UK National Health Service (NHS). Participants were given the new low-c..."