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Listen: Fibre Inclusion in Paediatric Enteral Feeding with Mikayla Profe-Fuchsloch
- 27/08/2024
Information for Healthcare Professional Use Only
In this episode of the Inside Medical Nutrition podcast, Dr. Linia Patel speaks with Mikayla Profe-Fuchsloch, a dietitian and assistant professor at the University of Coventry, about the impact of fibre inclusion in enteral nutrition for paediatric patients.
Fibre, which is classified by solubility, viscosity, and fermentability, increases stool weight, improves bowel regularity, and can balance stool frequency in both diarrhoea and constipation cases. All these features make it a useful addition to enteral nutrition.
It is not uncommon when managing paediatric patients with complex medical needs to have issues related with the gastrointestinal system. There can be issues with gut dysmotility and symptoms such as gastroesophageal reflux, delayed gastric emptying, diarrhoea and constipation.
In clinical practice, adding in a fibre supplement or choosing a fibre containing enteral feed can help to manage these issues. Current guidance from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition on how much fibre per day paediatric patients require recommends an increased fibre intake in children with neurodisabilities of 17-21g of fibre per day.1 This may be provided by the fibre from an enteral feed as well as the addition of a fibre supplement. Fibre supplements that are partially hydrolysed, such as Partially Hydrolysed Guar Gum (PHGG), which can help to improve bowel motions1. PHGG has been shown to work as a prebiotic, supporting the growth of beneficial gut bacteria2,3,4.
In addition, the combination of peptide-based feeds and fibre can help to improve tolerance and gastrointestinal symptoms.
Mikayla shares a case study where PHGG fibre supplementation significantly improved bowel motions and reduced medication reliance in a child with complex clinical conditions. She stresses the importance of a gradual introduction of fibre, monitoring tolerance through detailed symptom diaries, and involving parents in the decision-making process. She also points out the lack of standardised tools for fibre introduction, emphasising individualised approaches.
Listen to the full podcast episode to learn more about fibre inclusion in enteral nutrition and the role it plays.
1. Romano C, van Wynckel M, Hulst J, et al. J Pediatr Gastroenterol Nutr. 2017;65:242–264
2. Ohashi Y, et al. Benef Microbes 2015;6(4):451-455.
3. Yasukawa Z, et al. Nutrients 2019;11(9):2170.
4. Reider SJ, et al. Nutrients 2020;12(5):1257.
