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Enteral Nutrition
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.
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.
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.
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
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...
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
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.
Learn more about MCTs and their role in reducing fat malabsorption
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.
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.
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...