To read and download the case study click here. To read more on the nutritional profile for Peptamen AF click here. Further reading Motor Neurone Disease Association. www.mndassociation.org National Institute for Health and Care Excellence (NICE), (2016). Motor Neurone Disease: Assessment and Management. Available at: https://www.nice.org.uk/guidance/ng42/resources/motor-neurone-disease-assessment-and-management-1837449470149. Ng L, Khan F. Multidisciplinary care for adults with amyotrophic lateral sclerosis or motor neuron disease. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD007425. DOI: 10.1002/14651858.CD007425.pub2.

To read and download the case study click here. To read more on the nutritional profile for Peptamen HN click here. Further reading C.Dejong; F. Hammargyist et al. ESPEN guidelines on enteral nutrition: gastroenterology. European Journal of Clinical Nutrition Voulme 25, Issue 2. 2006. Pages 260-274. Henry CJK. Basal metabolic rate studies in humans: measurement and development of new equations. Public Health Nutrition 2005; 8 (7A): 1113-1152. Thomas B & Bishop J (Eds.) Manual of Dietetic Practice 4th edition. Blackwell Publishing Ltd; Oxford 2007, pp475-477. K, Spiroglou et al. Gastric emptying in children with cerebral palsy and gastroesophageal reflux. Paediatric Neurology 2004; 31 (3):177-182.

To read and download the case study click here. To read more on the nutritional profile for Peptamen HN click here. Further reading Another case study for Peptamen HN to read and download , click here

To read and download the case study click here. To read more on the nutritional profile for Peptamen Junior 0.6 click here. Further reading Management of weight gain in tube-fed children with neurodisabilities Weight Gain in Tube-Fed Neurodisability Children

To read and download the case study click here. To read more on the nutritional profile for Peptamen Junior 0.6 click here. Further reading Management of weight gain in tube-fed children with neurodisabilities Weight Gain in Tube-Fed Neurodisability Children

To read and download the case study click here. To read more on the nutritional profile for Peptamen Junior 0.6 click here. Further reading Management of weight gain in tube-fed children with neurodisabilities Weight Gain in Tube-Fed Neurodisability Children

To read and download the case study click here. To read more on the nutritional profile for Peptamen Junior 0.6 click here. Further reading Management of weight gain in tube-fed children with neurodisabilities Weight Gain in Tube-Fed Neurodisability Children

To watch a full webinar on case studies for Peptamen Junior 1.5kcal/ml ONS, from the Acceptability and Tolerance Study, click here. To read and download the case study click here. To read more on the nutritional profile for Peptamen Junior 1.5 click here.

To watch a full webinar on case studies for Peptamen Junior 1.5kcal/ml ONS, from the Acceptability and Tolerance Study , click here. To read and download the case study click here. To read more on the nutritional profile for Peptamen Junior 1.5 click here.

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This webinar, hosted by Dr. Helen Evans-Howells, focuses on recognising and managing cow’s milk protein allergy (CMPA) in primary care. It offers an overview of how to effectively work with patients who have CMPA in a community setting. Key learning points include the differences between allergies and intolerances, when to test for allergies and how to interpret results, and insights into the future of food allergies. The session concludes with an informative Q&A session.

Watch this insightful webinar focused on the terminology and guidelines surrounding at-risk feeding. We delve into the Royal College of Physicians (RCP) guidelines to clarify what constitutes at-risk feeding and the circumstances under which it applies. The session will highlight the crucial roles of the multidisciplinary team (MDT), including speech and language therapists and medical staff, in the shared decision-making process. Viewers can also explore a case history that underscores the significance of effective decision-making in this context. Additionally, we will discuss best-practice approaches for clear and defensible documentation that accurately reflects MDT decisions and prioritises patient-centred care. This webinar is valuable for professionals involved in the care of individuals with feeding risks, aiming to enhance understanding and improve outcomes.

Watch our webinar: “Dysphagia & Dietetics Management in Stroke Care”, where expert speakers Smruthi Venkat and Rachel Lenderyou discuss evidence-based practices for assessing and managing dysphagia, and the role of dietetics in addressing dysphagia-related challenges. The session aims to uncover strategies for safe and effective swallowing, and collaborative approaches to enhance patient outcomes.

Watch our webinar: “Assembly of the gut microbiome in early life”, where we will delve into the expertise of international expert Dr. Ruairi Robertson. He will share insights on the processes of infant gut microbiome assembly, the nutritional and environmental factors that affect this process and the outcomes for child health. The session aims to provide practical take-homes and advice regarding early life assembly of the gut microbiome.

Cow's milk allergy (CMA) is a prevalent food allergy in children globally, but diagnosing non-IgE mediated CMA is often difficult due to symptom overlap with functional gut disorderS. This webinar, led by Dr. Rosan Meyer, addresses newly published guidelines designed to assist healthcare professionals in diagnosing both IgE and non-IgE mediated CMA. The discussion will focus on the recently updated DRACMA and ESPGHAN guidelines, examining their potential impact on clinical practice.

This webinar focuses on the challenges of weaning infants with cow's milk allergy and the introduction of other food allergens. It highlights recent research on allergy prevention, including factors like maternal diet and the timing of introducing cow's milk, as well as insights from the LEAP study. Key discussions include the challenges of early introduction, including what’s happening in day-to-day practice, high reliance and low dosage of commercial foods and practical application. The session aims to cover emerging evidence on early allergen introduction and new trends in clinical practice.

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.

In this webinar Dr Helen Evans-Howells, a GP with an extended role in allergy, talks us through the use of amino acid-based formulas for the management of cow’s milk allergy (CMA). Dr Evans-Howells discusses the differences between IgE and non-IgE mediated allergy, the nutritional considerations in CMA and when to consider an amino acid formula, including relevant guidelines to support your clinical practice.

Two sessions in the third annual event for Blended Diet Network. Learn about how to support patients through the home-made blended diet journey alongside a tube feed with food-derived ingredients. Joanna will be discussing “Practical Approaches to Monitoring Patients on Blended Tube Diets”. Michelle will continue to focus on “Blended Diet in Enteral Feeding - Current Guidance”.

Two sessions in the third annual event for Blended Diet Network ; with two speakers Lorenza and Bailey.

Two sessions in the third annual event for Blended Diet Network. Learn about how to support patients through the home-made blended diet journey alongside a tube feed with food-derived ingredients. Joanna will be discussing “Practical Approaches to Monitoring Patients on Blended Tube Diets”. Michelle will continue to focus on “Blended Diet in Enteral Feeding - Current Guidance”.

In this webinar expert Paediatric Allergy Dietitian, Lydia Collins-Hussey, takes us through the Milk Ladder for the reintroduction of cow’s milk in children with CMPA and the latest research in this area. The session explores how to use the Milk Ladder, the different published Milk Ladders available, as well as how and when to move your patients along the ladder. Take this opportunity to increase your awareness and confidence with cow’s milk reintroduction.

In this webinar, Professor Yvan Vandenplas and Dr. Rosan Meyer, on behalf of the CoMiSS expert group, discuss the global prevalence of cow’s milk protein allergy (CMPA), the accepted methods for diagnosis and the subsequent challenges faced with diagnosis, particularly in relation to non-IgE mediated CMPA. We invite you to watch and learn from international experts why the diagnosis is so challenging and what healthcare professionals can do to try and minimise over and under-diagnosis.

Cow’s milk allergy (CMA) is one of the most common food allergies worldwide. The diagnosis remains a challenge due to overlapping symptoms with other common childhood illness, and both under and over diagnosis have negative consequences. We welcome you to watch and learn from International Experts how CoMiSS® can help connect the dots in clinical practice to provide fast and effective evaluation of symptoms related to cow's milk and improve health outcomes.

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.

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.

Recorded webinar of Dr Ana Canton Blanco discussing the scientific evidence supporting the EAT-10 validation tool for dysphagia.

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.

Presentation covers how a multidisciplinary team involving a speech and language therapist, dietitian, and a nurse work together to manage patients with Motor Neurone Disease who have swallowing difficulties.

At the end of the presentation, you should have an understanding of the following questions: 1) What is cognitive dysphagia? 2) Where might you see cognitive dysphagia? 3) What are cognitive feeding behaviours? 4) What are some practical strategies on how to support those with cognitive feeding behaviours?

Dysphagia, Aspiration & Infection – Including does aspiration pneumonia even exist? The View from a Speech and Language Therapist and Physiotherapist

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.

Join specialist dietitians from the Royal Marsden Hospital, who will discuss a case study on the management of enteral nutrition for a patient with neuroendocrine tumour of the pancreas.

In this video we will view the summary results of a systemic review paper by Vinas and colleagues entitled “The hydration status of adult patients with oropharyngeal dysphagia and the effect of thickened fluid therapy on fluid intake and hydration: Results of two parallel systematic and scoping reviews”.

Kate Grimshaw qualified as a dietitian in the UK in 1989 after completing a Post Graduate Diploma in Human Nutrition and Dietetics (Her first degree was in Human Biology). She has since worked in a number of clinical dietetic posts. In 1995 she completed her MSc in Human Nutrition and in 2003 gained a post-graduate diploma in Allergy. In 2012 she completed her PhD looking at infant feeding practices in the first year of life and the development of food allergy. Many aspects of food allergy and nutrition are of interest to her including aetiology, diagnosis and treatment of food allergy and also the nutritional adequacy of exclusion diets in children and adults. The importance of the whole diet and its influence on the gut microbiome and immune system are of particular interest following on from her PhD findings. In September 2018 she moved to work at Salford Royal NHS Foundation Trust as dietetic manager but she continues to work clinically within the food allergy field and provides dietetic support to adult patients with both IgE and Non-IgE mediated food allergy at Salford. As well as her research, clinical and management roles, Kate lectures on the Food Allergy Module of the MSc in Allergy at the University of Southampton and also to a number of University Dietetic Training programs. She is also research member of the Food Allergy Specialist Group of the British Dietetic Association. Find out more about Simplink(R) - a unique direct to gastrostomy bolus feeding method - Compleat® paediatric SimpLink® | Nestlé Health Science Links to further reading Learn more about the real-world evidence for tube feed with food-derived ingredients here: Real World Evidence Infographic | N+ Hub Read Compleat® paediatric case studies Learn more about Compleat paediatric: Compleat® paediatric for professionals | Nestlé Health Science

In this session Charlotte Cole explores the use of blended diets in adults, discussing the importance of patient autonomy in the care of those who are tube fed and reflects on what is observed in her own practice as a community dietitian working with those who have neurological conditions. A graduate of Oxford Brookes and Kings, London (1996), Charlotte has worked as a Senior Dietitian in both dietetic and management roles in the NHS; acute (HIV / Head & Neck Cancer / Tropical Diseases) and community settings (home enteral feeding) in London and the South East of England. A second career of 5 years in local Government and returning to dietetics to specialise in neurological rehabilitation in West Sussex. A particular interest in communication and counselling skills, gastrostomy feeding, legal aspects of decision making and palliative care. Links to further reading Learn more about the real-world evidence for tube feed with food-derived ingredients here: Real World Evidence Infographic | N+ Hub Read Compleat® paediatric case studies Learn more about Compleat paediatric: Compleat® paediatric for professionals | Nestlé Health Science

A review of the latest evidence and guidelines for the use of blended diets for tube feeding. Hazel is a Paediatric Dietitian based in South West Scotland. She has over 20 years’ extensive experience working within paediatric dietetics in both district general and tertiary centres. She has participated in research and has several journal publications. Two years ago, she decided to expand into private practice and enjoy the variety of supporting families within both NHS and private settings. She is also involved in the hosting of modules for the Masters in Paediatric Dietetics at Plymouth University. Most of her clinical experience is within gastroenterology, managing patients with IBD, leading a dietetic coeliac service, supporting families with enteral feeding and managing the complex enteral feeding patient. She has been providing blended diets to families for a significant period of time and is excited by the opportunities that blended diet gives the patient, families and dietitians. Compleat paediatric brand page - Compleat® | Nestlé Health Science Links to further reading Learn more about the real-world evidence for tube feed with food-derived ingredients here: Real World Evidence Infographic | N+ Hub Read Compleat® paediatric case studies Learn more about Compleat paediatric: Compleat® paediatric for professionals | Nestlé Health Science

Question is part of “Fibre Maze; Influence on Gut Health and GI disorders” webinar. The answer is delivered with Dr Graeme O’Connor RD PhD , Clinical Academic Lead , Great Ormond Street Hospital, UK & Dr Anna Rybak MD, PhD ,Consultant Paediatric Gastroenterologist ,Great Ormond Street Hospital , UK. To watch the full length of the sessions Fibre Maze: Influence on Gut Health and GI disorders Session 1 click here. & Session 2 click here. & for Q&A session click here. & for PHGG fibre Expert Experience click here. To read and download more on PHGG fibre “Fibres in paediatric functional gastrointestinal disorders. Practical considerations from clinical cases” click here.

Question is part of “Fibre Maze; Influence on Gut Health and GI disorders” webinar. The answer is delivered with Dr Anna Rybak MD, PhD ,Consultant Paediatric Gastroenterologist ,Great Ormond Street Hospital , UK. To watch the full length of the sessions Fibre Maze: Influence on Gut Health and GI disorders Session 1 click here. & Session 2 click here. & for Q&A session click here. & for PHGG fibre Expert Experience click here. To read and download more on PHGG fibre “Fibres in paediatric functional gastrointestinal disorders. Practical considerations from clinical cases” click here.

Question is part of “Fibre Maze; Influence on Gut Health and GI disorders” webinar. The answer is delivered with Dr Graeme O’Connor RD PhD , Clinical Academic Lead , Great Ormond Street Hospital, UK. To watch the full length of the sessions Fibre Maze: Influence on Gut Health and GI disorders Session 1 click here. & Session 2 click here. & for Q&A session click here. & for PHGG fibre Expert Experience click here. To read and download more on PHGG fibre “Fibres in paediatric functional gastrointestinal disorders. Practical considerations from clinical cases” click here.

Question is part of “Fibre Maze; Influence on Gut Health and GI disorders” webinar. The answer is delivered with Dr Graeme O’Connor RD PhD , Clinical Academic Lead , Great Ormond Street Hospital, UK. To watch the full length of the sessions Fibre Maze: Influence on Gut Health and GI disorders Session 1 click here. & Session 2 click here. & for Q&A session click here. & for PHGG fibre Expert Experience click here. To read and download more on PHGG fibre “Fibres in paediatric functional gastrointestinal disorders. Practical considerations from clinical cases” click here.

Question is part of “Fibre Maze; Influence on Gut Health and GI disorders” webinar. The answer is delivered with Dr Anna Rybak MD, PhD ,Consultant Paediatric Gastroenterologist ,Great Ormond Street Hospital , UK. To watch the full length of the sessions Fibre Maze: Influence on Gut Health and GI disorders Session 1 click here. & Session 2 click here. & for Q&A session click here. & for PHGG fibre Expert Experience click here. To read and download more on PHGG fibre “Fibres in paediatric functional gastrointestinal disorders. Practical considerations from clinical cases” click here.

Question is part of “Fibre Maze; Influence on Gut Health and GI disorders” webinar. The answer is delivered with Dr Anna Rybak MD, PhD ,Consultant Paediatric Gastroenterologist ,Great Ormond Street Hospital , UK. To watch the full length of the sessions Fibre Maze: Influence on Gut Health and GI disorders Session 1 click here. & Session 2 click here. & for Q&A session click here. & for PHGG fibre Expert Experience click here. To read and download more on PHGG fibre “Fibres in paediatric functional gastrointestinal disorders. Practical considerations from clinical cases” click here.

Question is part of “Fibre Maze; Influence on Gut Health and GI disorders” webinar. The answer is delivered with Dr Anna Rybak MD, PhD ,Consultant Paediatric Gastroenterologist ,Great Ormond Street Hospital , UK. To watch the full length of the sessions Fibre Maze: Influence on Gut Health and GI disorders Session 1 click here. & Session 2 click here. & for Q&A session click here. & for PHGG fibre Expert Experience click here. To read and download more on PHGG fibre “Fibres in paediatric functional gastrointestinal disorders. Practical considerations from clinical cases” click here.

Question is part of “Fibre Maze; Influence on Gut Health and GI disorders” webinar. The answer is delivered with Dr Graeme O’Connor RD PhD , Clinical Academic Lead , Great Ormond Street Hospital, UK. To watch the full length of the sessions Fibre Maze: Influence on Gut Health and GI disorders Session 1 click here. & Session 2 click here. & for Q&A session click here. & for PHGG fibre Expert Experience click here. To read and download more on PHGG fibre “Fibres in paediatric functional gastrointestinal disorders. Practical considerations from clinical cases” click here.

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.

In 2023, Nestlé Health Science conducted a survey of UK healthcare professionals with the aim of understanding more about gastrointestinal symptoms during cancer treatment. View our short animation for the survey highlights, or for more detail we’ve created a downloadable infographic below.

The GA²LEN 2022 guideline has been developed by a multidisciplinary task force and focuses on the ways healthcare professionals can best manage diagnosed food allergy in infants, children, adolescents, and adults.  Dietitian Dr Kate Grimshaw delves deeper into what these guidelines are and how they can support best practise management in food allergies.   Download Certificate

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.

What are the key aspects of diagnosing cow’s milk allergy and when should you refer into secondary care?  Highly specialised Paediatric Dietitian Sophie Rawlings explores best practise in the management of cow’s milk allergy in this CPD accredited module, covering the different forms and presentations of cow’s milk allergy and the gold standard for diagnosis of cow’s’ milk allergy.   Download Certificate

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.

Good oral health and mouthcare is critical to management of dysphagia patients and a topic of growing discussion.

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

Q&A session for "Exploring Different Options for Enteral Nutrition" webinar held on 15th of September, 2022.. The speakers is discussing the questions posted by the audience.

Third session of "Exploring Different Options for Enteral Nutrition" webinar held on 15th  of September, 2022. Stephanie Wickfield is Exploring feeding modalities in the Nutritional management of chyle leaks.

Second session of "Exploring Different Options for Enteral Nutrition" webinar held on 15th  of September, 2022. Nirouz Zarroug is giving a dietetic experience in the impact on Nutrition Status for patients in Stem Cell Transplantation. 

First session of "Exploring Different Options for Enteral Nutrition" webinar held on 15th of September, 2022. Dr. Mona Bajaj-Elliott will go through impact of diet on shaping the  gut microbiota with current challenges and recommendations.

Learn more about MCTs and their role in reducing fat malabsorption

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.

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      

Lee and his parents share their experience with the ModuLife Program and the Crohn's Disease Exclusion Diet (CDED).

Experts, supported by Nestlé Health Science, have introduced a simple to use scoring tool – the Cows’ Milk Related Symptom Score (CoMiSSTM) – enabling primary healthcare professionals to more efficiently interpret symptoms and consider earlier intervention. CoMiSSTM will significantly aid in raising awareness of CMA to help support in the diagnosis of this common infant allergy.

The aim of this webinar is to aid primary care individuals in the diagnosis and management of cows' milk protein allergy. Evidence suggests that it can take an average of 10 weeks and 4 visits to a healthcare professional to get a diagnosis of cows' milk allergy (CMA).1

Choosing appropriate side dishes for dysphagia patients can be challenging and mashed potato can get repetitive. Gary Brailsford shares tips on how to create rice alternatives with cauliflower and broccoli, adding both colour and vegetables on to the plate in a creative way. Suitable for IDDSI levels 4, 5 and 6.

How dietitians have supported patients and their families through the Food for Special Medical Purposes (FSMPs) story as a series of twelve case studies describing the improved clinical and quality of life outcomes.   Download the PDF

Kristian discusses that the introduction of solids shouldn’t change due to cows’ milk allergy. He gives recommended timelines for this introduction and other weaning advice.

Kate discusses  how the introduction differs between IgE and non-IgE mediated allergy. She discusses how, with suitable patients, the milk ladder and how it works. 

Kate discusses how important it is for the child to be on the right formula. She discusses how there is evidence that an EHF could be seen as the first step of the milk ladder, introducing a child back onto dairy products to see if they have outgrown their allergy. She also highlights cases where this shouldn't be tried - these cases a child should be under the care of a paediatric allergy dietitan.

Kristian discusses how taste buds of infants mean they don’t notice taste differences in milks. He mentions how some formula taste better than others, specifically lactose containing formulas. He also mentions a method of titrating from one milk to another.

Kate discusses how adding flavours isn’t recommended - she further discusses how formulas containing lactose can taste better and therefore may be tolerated better.

Helen discusses the amount of formula and how it varies by infant condition and weight. She also gives a rough guide based on age.

Helen discusses the vitamins and minerals needed with both breastfed infants and formula fed infants both with or with cows’ milk allergy.

Kristian discusses how it isn’t advised to concentrate up a feed as a norm but further discusses special areas under the advice of a dietitian where it might occur.

Kristian discusses that guidance says that soya formula shouldn’t be used for Infants under 6 months of age and the reasons behind this.

Helen discusses that all amino acid formulas are suitable for a halal diet. She tells us that only SMA Althera is currently suitable for a halal diet in the extensively hydrolysed formulas.

Kate discusses that approximately 90% of patients should tolerate an EHF. She further discusses how an EHF should be first line choice in dietary management of cows’ milk allergy. She also highlights the areas where an amino acid formula should be used.

Helen discusses how and why you would order samples of formula for patients.

Helen discusses the difference between an EHF and an AAF. The differences between certain EHFs and when to use an AAF. 

Kate discusses the much misunderstood differences between lactose intolerance and cows’ milk allergy. She also discusses the different types of lactose intolerance.

Helen discusses the importance of history taking to help diagnose IgE mediated allergy and also the tell tale signs that occur with this type of allergy. She also discusses the different tests that can be taken to diagnose the allergy.

Helen discusses the difficulties in identifying non-IgE mediated allergy. She discuses methods to help inform the likelihood of allergy and then how to perform an elimination diet and reintroduction to diagnose the allergy.

Helen discusses the differences between IgE and non IgE allergy and the different body reactions between the two types of allergy. She also mentions ways of identifying between the two.

Kate discusses the importance of breastfeeding and steps that can be taken to maintain this in a child with cows’  milk allergy. She discusses the need for close dietary management to make sure vital nutrients deficiencies don’t occur with a dairy exclusion diet.

Helen discusses the differences in the symptoms associated with both IgE and Non-IgE mediated cows’ milk allergy. She discusses where symptoms which appear in different parts of the body. Helping you to not only identify cow’s milk allergy but what type it may be.

The perfect alternative to your traditional party cakes; whether it’s for a special gathering or a birthday, the celebration cake is a great way to make sure your dysphagia patients can be included. Watch now for a step-by-step guide on how to deliver this decadent dessert.

You asked and we listened! The Cooking with Confidence video series is almost here. So, what can you expect in season one of our ‘Cooking with Confidence’ series? Brought to you by renowned Dysphagia Chef Gary Brailsford, from menu planning to perfecting your presentation, in this series we provide a step-by-step guide on how to create recipes that bring back the joys of food.

Do you use anthropometric measurements in your practice? This technique can prove helpful in a number of settings; from hospital admissions to virtual consultations. Explore our educational resources and how-to videos to learn more.

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.

Nestlé Health Science is proud to host our next webinar ‘Risk taking in Dysphagia management: should we be bolder?’  This webinar aims to stimulate professional debate and progress practice in dysphagia management. An understanding of risk and risk-aversion is explored in the context of healthcare, how this relates to supporting patients with dysphagia by speech and language therapists and if a balance is being achieved in risk management, rehabilitation and quality of life.

A webinar explaining the dietary management of Cows’ Milk Allergy in primary care. 

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.

Meet Sandy. After being diagnosed with Type 2 Diabetes in November 2014, she now faces a tough choice to lose weight or begin medication. In the hope of achieving remission from her diabetes, Sandy embarks on a plan to help her lose weight.

This animation shows what happens during the normal swallowing process, in a person who does not have dysphagia. It provides a detailed animation of the normal swallowing process, including a step-by-step explanation of each stage of swallowing and the role of key anatomical structures. Please feel free to use these in practice with patients and/or for internal training.

Educational video demonstrating how to support someone with Dysphagia while they eat

Video demonstrating the swallowing process for thickened food or water

Video demonstrating the swallowing process if suffering from dysphagia

This webinar explores the scientific evidence behind the controversial topic of thickened liquids as an intervention for people with dysphagia. The impact of liquid thickness on swallowing safety, swallowing efficiency and risk of aspiration pneumonia will be reviewed, along with evidence regarding alternatives to thickened liquids. The webinar will wrap up with best practice recommendations for clinicians when recommending diet texture modifications for people with dysphagia.

Professor Antonella Muraro, Paediatric Allergist, discusses the tests available to help support diagnosing CMA in infants. Filmed 2017.

The diagnosis of CMA can be difficult and a diagnosis must be confirmed. Clinical symptoms, elimination and challenge must all be considered. Filmed 2017.

Dr Carina Venter discusses the diagnosis and management of food protein-induced enterocolitis (FPIES) and eosinophilic esophagitis (EOE) in infants and young children. Filmed in Oct 2016.

Professor Mike Thomson, Paediatric Gastroenterologist, discusses cows’ milk allergy and the impact of delayed diagnosis, the typical symptoms and how it can be dietary managed. Filmed in Sept 2016

Rachel DeBoer, specialist paediatric allergy dietitian, discusses the challenges faced when weaning (complementary feeding) infants with CMA. Filmed in May 2017.

Food allergies can have an impact on eating habits and food intake. This includes CMA where feeding difficulties has been described as a possible feature. Dr Polly James, paediatric clinical psychologist, discusses practical tips for managing feeding aversions in the allergic child. Filmed in May 2017

Human milk contains bioactive components that confer protection on the newborn. These include complex carbohydrates called Human Milk Oligosaccharides (HMO). Research is revealing the full extent of the beneficial properties of HMOs.

Lactose intolerance is one of the more common forms of food intolerance and is often confused with cows' milk allergy. This video explains the differences in both symptoms, diagnosis and treatment. It also explains the different types of lactose intolerance.

HMOs, the third solid component of human milk, are complex structures with a high potential for specific functions. HMOs and prebiotic oligosaccharides have completely different structures, which impact on their functions. Additionally to prebiotic effects, HMOs reduces adhesion of pathogens and have immune modulator effect.

The process of diagnosing a child with a cows’ milk allergy (CMA) can be difficult as the symptoms of CMA are non-specific, making the allergy often difficult to detect. Our video goes through the first steps to diagnosing the condition (date: 01/06/2017)

The first 1,000 days of life are a window of opportunity to set solid foundations for infants’ future health. This period is a time of rapid physiological change and plasticity with significant potential for lasting effects.1 It is also a period of heightened vulnerability.2

With ever increasing pressures on healthcare systems and the need to move to online consultations this webinar looks at introducing clinicians to the Cow’s Milk-related Symptom Score Tool - CoMiSS®. Exploring the latest evidence for this simple, fast and easy-to-use awareness tool for non-IgE mediated cows’ milk-related symptoms, this webinar will include practical examples of how the CoMiSS® tool can be used in practice and how it can aid digital consultations as part of a cow’s milk protein allergy digital pathway.

In this video, Jacqui Griffiths, MND Dietitian from Leeds MND Care Centre discusses the management of a patient with Motor Neurone Disease, who developed reflux and regurgitation on commencing gastrostomy bolus feeding. Despite the use of various enteral and oral feeds, his symptoms persisted, and he lost approximately 8% of his body weight in 9 months. After commencing Peptamen® AF, a 100% whey peptide formula with 50% of fat from MCT, his symptoms resolved and his weight stabilised. He continues to tolerate enteral feeding well after 8 months on his new feed and reports his quality of life has improved.

In this video, Elaine Mealey, Community Paediatric Dietitian from Whittington Health HNS, discusses the importance of E-learning and presents our BDA accredited CPD E-learning module which Nestle Health Science have created in collaboration with Elaine as part of our wider CPD programme.

Amanda Wall, Paediatric Dietitian and Nadia Aslam, Adult Dietitian, discuss the transition of patients from paediatric to adult HEF services.

Paula Hynd, from the Wellcome Trust for Mitochondrial Research in Newcastle discusses the disease area and its importance for dietitians, the role dietitians play in the management of patients and how dietitians can impact patient care.

Dr Anton Emmanuel provides a thought-provoking update on the relationship between the brain and the gut. Drawing on his extensive experience in neurogastroenterology, and exploring emerging research in the field, he provides expert insight in to this evolving-discipline. The pathophysiology of gastrointestinal dysfunction in neurological disorders, such as Multiple Sclerosis, is examined.

Dr Nikhil Sharma explores the role of the gut microbiome in neurological disorders, and offers fascinating insight into his forthcoming research involving faecal microbiota transplantation in motor neurone disease.

Ella Segaran provides her perspective on gastrointestinal dysfunction in acute neurological disorders, focusing on critically ill traumatic brain injured patients. By drawing on her own experience as well as appraising the current evidence base, she offers practical solutions for improving the nutritional care of this vulnerable patient group.

Karen Green is well known in dietetics for her contribution to the Manual of Dietetic Practice and BDA Best Practice Guidelines on Parkinson’s disease. In this lecture, she explores the impact of Parkinson’s disease on the gut, including the management of gastroparesis, constipation and small intestinal bacterial overgrowth.

Vitamin D status in the UK is a hot topic. Hayley Kuter a paediatric home enteral tube feed dietitian at Royal Manchester Children’s Hospital has a keen interest in vitamin D and was invited to provide us with an overview of vitamin D, risk factors for deficiency in neuro-disability and an update on SACN guidelines on vitamin D. Hayley also walks us through her recent study report on vitamin D status of gastrostomy fed children with special needs.

Gerard Minor, is a physician assistant specialising in paediatric gastroenterology and nutrition in Florida. He has carried out a study using Peptamen Jr that was presented at the NASPGHAN conference, Feb 2016, and published in the journal of Global Paediatric Health. Gerard spoke at our ND study day in May 2016 and we recorded his presentation.

What do leading IBD experts say about the Crohn's Disease Exclusion Diet (CDED)? Learn more from the experts behind the diet and the clinical trials in the video from the first "CDED Expert" training day that took place in Copenhagen, March 2019.

A webinar in collaboration with Nestlé Health Science, hosted by Professor Mary Hickson and Alison Smith.

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.

Watch our roundtable discussion about a new trial investigating achieving Type 2 diabetes remission through a remote low-calorie diet programme. Chaired by Oviva’s VP Clinical Lucy Jones, who was joined by a panel of expert speakers from the MIDDAS research team, this isn’t one to miss. Watch to discover: How 53% of the patients in the trial put their diabetes into remission How the research translates into delivering this care in clinical practice How a digital programme can benefit both the patient and the NHS More key results from the trial The programme used in the trial supports people living with Type 2 diabetes to achieve rapid weight loss using an 800kcal diet for a 12-week period, through digitally supported delivery of regular one-to-one support from a multidisciplinary team via the telephone and the Oviva NHS Digital approved app.

Although it’s a highly prevalent condition in older adults, awareness of the condition remains low. Nutrition plays a vital role in the management of this illness, so Nestlé Health Science have jointly sponsored the Aging in Motion Coalition, led by Dr Jack M. Guralnik and Dr Bruno Vellas. We want to raise awareness in hope of leading to better care and quality of life for those affected. Watch and share this video to learn more.

In this webinar, Dr. Harvie will discuss the application of low-energy restricted diets as part of intermittent fasting as an alternative strategy for weight management and type 2 diabetes. Dr. Harvie will also discuss the MIDDAS study which evaluated the acceptability and effectiveness of an intermittent low-energy diet versus continuous low-energy diet in people living with Type 2 diabetes.

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.

The article explores the prevalence and impact of GI intolerance in oncology patients and the nutritional strategies used to manage these intolerances, with a particular focus on enteral feeding. It examines the evidence supporting the use of peptide-based enteral feeds with food derived ingredients, in improving nutrient absorption and GI tolerance.

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 brochure gives an overview on the EAT-10 tool and its validation covering it’s use in the diagnosis, screening, and intervention of dysphagia. Eating Assessment Tool 10 (EAT-10) is a list of 10 questions that can be completed in approximately 2 minutes and helps to measure to what extent a patient may experience swallowing difficulties and risk of dysphagia.

Objective: EAT-10 helps to measure swallowing difficulties. It may be important for you to talk with your physician about treatment options for symptoms.

The weaning guide contains recipes developed with leading dietitians from across the UK to help your patients' carers prepare milk-free recipes. The weaning guide can help give them confidence, that as their child grows, family meals can be adapted to make them suitable for CMA.

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.

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...

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...

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.

The Effective management of each resident’s hydration and nutrition can prevent complications and improve quality of life for patients. Explore NHS Enhanced Care in Care Homes framework’s best practice guidance for healthcare professionals.

The needs of dysphagia patients is diverse and can vary from patient to patient. To keep patients safe, it is important that the right questions are being asked. Read the latest Care Quality Commission guidelines for guidance and support on key considerations in the management of dysphagia. 

This is a great recipe for dysphagia patients looking to enjoy a biscuit with their afternoon tea. Suitable for IDDSI levels 4,5 and 6 this recipe provides a step-by-step guide on soaking solution for biscuit.

Providing more choices for your dysphagia patients can help encourage patients to drink and may improve hydration. This IDDSI 3 level smoothie recipe is a great option for patients looking for a fruity drink or a refreshing summer beverage.

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      

The successful introduction of Resource® ThickenUp™ Clear took place across the Leeds Teaching Hospitals NHS Trust (LTHT) in January 2016. This includes: Leeds General Infirmary St James’s University Hospital Chapel Allerton Hospital The speech and language therapy LTHT outpatient service Why switch thickener? The switch from the previous starch-based thickener was ...

N. Vilardell1, L. Rofes2, V. Arreola1, R. Speyer3,4, P. Clave´1,2,3,5 Received: 16 December 2014 / Accepted: 11 November 2015 / Published online: 25 November 2015 © Springer Science+Business Media New York 2015 N. Vilardell natalia.vilardell@hotmail.com 1 Unitat d’Exploracions Funcionals Digestives, Department of Surgery, Hospital de Mataro´, Universitat Auto`no...

Purpose Diet modification is an established first-line compensatory technique for dysphagia management, and thickeners are used to modify liquids. Commercial thickening agents are used to decrease the flow rate of liquids, and allow patients more time to initiate the swallow. Patients do not always like thickened fluids and so compliance can be difficult to achieve. We unde...

For people with dysphagia, it is commonly recommended for fluids to be thickened in order to assist with bolus control and help reduce the risk of choking and aspiration.1-4 However, it has been found that many patients report a dislike of thickened fluids, especially thicker consistencies, thus reducing their quality of life and increasing their risk of dehydration from..

Bolus manipulation is a primary treatment strategy in the management of oral-pharyngeal dysphagia. The use of thickening agents to alter bolus rheology is particu-larly commonplace; however, the precise effects of these alterations on swallowing remain uncertain. The purpose of our study, a prospective, double-blind clinical trial (Level 1b), was to investigate the effects o...

S. Popa Nita •  M. Murith •  H. Chisholm • J. Engmann •  Received: 5 March 2012 / Accepted: 10 December 2012 / Published online: 14 February 2013 The Author(s) 2013. This article is published with open access at Springerlink.com S. Popa Nita M. Murith H. Chisholm J. Engmann (&) Nestle´ Research Center, Nestec Ltd, Vers-chez-les-Blanc, PO Box 44, 1000 Lausanne 26,..

NESTLÉ HEALTH SCIENCE 2016 Aim To undertake a trial to compare Resource® ThickenUp™ Clear against their current starch based thickener and address the current difficulties. Method Nestlé Health Science provided samples of Resource® ThickenUp™ Clear to the Stroke Unit to trial this thickener The trial consisted of numerous evaluation components: Taste test – included staff and patients with dysphagia ...

Eat10 – A quick and easy screening tool, validated to identify those at risk of Dysphagia.

Resource ThickenUp Clear Clinical Evidence

The symptom diary is for a carer of an infant suffering from signs and symptoms that could be linked to Cow's Milk Allergy (CMA) or other food allergies. Help your patients carer prepare for their next health visit, learn about common symptoms, which will help inform you to make a correct diagnosis.

NESTLÉ HEALTH SCIENCE 2015 Aim To collect user feedback and fluid intakes of residents on a thickening powder for management of dysphagia to support a possible change from their current starch based thickener to Resource® ThickenUp™ Clear in Four Seasons care homes in Northern Ireland. Method 2 week fluid intake chart data collection whilst on current thickener across 2 sites Nestlé Health Science deliver...

L. Rofes*, V. Arreola†, R. Mukherjee‡, J. Swanson§ & P. Clave*,† *Centro de Investigacion Biomedica en Red de enfermedades hepaticas y digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain. †Unitat de Proves Funcionals Digestives, Department de Cirurgia, Hospital de Mataro, Universitat Autonoma de Barcelona, Mataro, Spain. ‡Nestle Research Center, Nestec Ltd, L...

Rofes L, Arreola V, Mukherjee R, Clavé P Neurogastroenterol Motil 2014 Sep;26:1256-65. Aim: To re-validate the accuracy of the Volume-Viscosity Swallow Test (V-VST) for Clinical Assessment by using a new thickening agent with an exclusive formula (ThickenUp® Clear) on 120 patients with oropharyngeal dysphagia associated with age and neurological pathology. Results: The study sh...

Herentry K, et al. European Geriatric Medicine. 2011;2(S24-S206.). Excellent Compliance1: Does not affect colour, taste and odour of hot or cold liquids or foods. Flavourless & Odourless No lumps in various liquids Practically transparent in water 98% of professionals state that it helps improve compliance* Easy to Prepare6 The results obtained with Resource® ThickenUp® Cle...

Introduction Prescribed thickeners are used to thicken fluids to a more viscose consistency than normal, because drinking thicker fluids has long been thought to reduce the risk of aspiration for people with dysphagia. A recent systematic review has identified that thickening liquids can reduce risk of aspiration.1 Many older people live with dysphagia, and a recent review study2 fou...

Hear from independent Speech and Language Therapist, Sandra Robinson, on the role of thickeners, such as Resource® ThickenUp® Clear, when it comes to supporting those with dysphagia.

Hear from independent Speech and Language Therapist, Sandra Robinson, on the role of thickeners, such as Resource® ThickenUp® Clear, when it comes to supporting those with dysphagia.

THE DIETARY MANAGEMENT OF A COMPLEX COWS’ MILK ALLERGY PATIENT USING ALFAMINO® A 2 month old baby was referred for Nasogastric feeding following an episode of bronchiolitis. The baby had a past medical history of atopic eczema and was previously managed by the GP and Allergy & Dermatology team. Patient’s background, medical history, physical diagnosis The patient was born full term in August 2014. Pre-October 2014, there was one admission to hospital fo...

A practical approach to managing a CMA infant with Althera™ Cows’ Milk Allergy (CMA) can occur in 1.8% - 7.5% of infants in the first year of life.1 The allergy is defined as an adverse reaction to the proteins in milk with most children growing out of their allergy by the time they reach one year. The treatment consists of the exclusion of cows’ milk from the infant’s diet. There...

Cows’ milk allergy (CMA) is one of the major food allergies during infancy and childhood. Hypoallergenic formulas can be necessary for managing infants and children with severe CMA. According to the American Academy of Pediatrics (AAP), a formula is “hypoallergenic” if it does not provoke allergenic activity in 90% of infants or children with confirmed CMA with 95% confid...

" MANAGING COWS’ MILK PROTEIN ALLERGY WITH ALFAMINO® Overview of cows’ milk protein allergy in infants Cows’ milk protein allergy (CMPA) is one of the most common food allergies in infants.1 Symptoms of CMPA include :  Gastrointestinal (32-60% cases) Skin (5-90%) Anaphylaxis (0.8-9%) Respiratory Many of these symptoms overlap. CMPA can be classified into two groups: IgE mediated or non-IgE mediated (delayed hypersensitiv..."

" THE USE OF AMINO ACID FORMULA IN THE DIETARY MANAGEMENT OF SEVERE INFANT COWS’ MILK ALLERGY Approximately 2-7.5% of infants have symptoms of CMA1 whilst symptoms suggestive of Cows’ Milk Allergy (CMA) may be encountered in up to 15% of infants,  emphasising the importance of controlled elimination/milk challenge procedures2. The diagnosis and treatment pathways for cases of CMA are well documented and several guidelines exist to support the healthcare professional in..."

Cows’ milk protein allergy (CMPA) is the leading cause of allergy in infants. Previous studies assessing milk formulas with extensively hydrolyzed proteins have reported issues such as reactivity to residual allergens, bitter taste, and the impracticability of adding lactose.

During the last decade, the prevalence of allergic diseases in infants and children has increased significantly either through better awareness of the symptoms or through generally more children being affected.1-3 Therefore, it is no surprise that the numbers of children presenting to clinics in district general hospitals has also increased.4-5 Diagnosis of true milk allergy is key...

Differentiating milk allergy (IgE and non-IgE from lactose intolerance: understanding the underlying mechanisms and presentations.

There is much confusion between the diagnostic terms ‘lactose intolerance’ and ‘cows’ milk allergy’, which are often used interchangeably, resulting in the potentially incorrect clinical management of these two distinct conditions.

To characterize the peptide profile of a whey-based, extensively hydrolysed formula (eHF) prepared with a non porcine enzyme blend, and to assess whether it meets the hypoallergenicity criteria of the Ame...

The aim of the symposium was to share learnings from the recently established European Academy of Allergy and Clinical Immunology (EAACI) Task Force on special products for cow’s milk protein allergy (CMPA), with the intention of providing an overview on controversies regarding extensively hydrolysed formulas (eHFs), their utility, and the validity of the definition ‘special products ...

This symposium took place during the 2018 meeting of the European Academy of Allergy and Clinical Immunology (EAACI). Focussing on the fundamental issues of suboptimal management of patients with cow’s milk protein allergy (CMPA), the speakers discussed key themes for optimising management.

To assess if an amino acid-based formula supports normal growth in infants with cow's milk protein allergy (CMPA).

The CoMiSS score was developed as an easy-to-use awareness tool for primary health care providers to increase the awareness of the most common symptoms of cow's milk protein allergy (CMPA) and the evolution of symptoms during a therapeutic intervention. The purpose of the study was to evaluate the score in infants with symptoms indicative of CMPA and to evaluate...

To determine whether an extensively hydrolyzed formula (EHF) supplemented with two human milk oligosaccharides (HMO) was tolerated by infants with cow’s milk protein allergy (CMPA). Methods: A whey-based EHF (Test formula) containing 2′fucosyl-lactose (2′FL) and lacto-N-neotetraose (LNnT) was assessed for clinical hypoallergenicity and safety. The Control formula was...

Prof O’Mahony began by discussing how the human gut is colonised by a wide diversity of microbes. He went on to review the evidence for how they exhibit highly evolved synergistic relationships to provide essential biological functions to the host and how the gut microbiome is influenced by many factors in early life. Prof Renz proceeded to describe the importance of establishing a s..

16 weeks old, female twins were identified on EMIS search at a GP practise by an Oviva community dietitian for review. They were not already under the care of a dietitian and had both been started on Neocate LCP® for suspected cows’ milk allergy (CMA) at 6 weeks old by a paediatrician. The dietitian successfully switched both twins to SMA Alfamino and later stepped them down to SMA Althera.

This case study discusses the management of a patient with Motor Neurone Disease, who developed reflux and regurgitation on commencing gastrostomy bolus feeding. Despite the use of various enteral and oral feeds, his symptoms persisted, and he lost approximately 8% of his body weight in 9 months. After commencing Peptamen® AF, a 100% whey peptide formula with 50% of fat fr...

A 22 year old gentleman, diagnosed with cerebral palsy (a neurological condition that is specifically caused by problems in the part of the brain responsible for controlling muscles), was referred to the Dietetic department.1 He also had a differential diagnosis of Inflammatory Bowel Disease (IBD), which is the general term used to describe ulcerative colitis a...

Mitochondrial myopathy is a neuromuscular disease caused by damage to the mitochondria. These are small, energy-producing structures that work as the cell’s power plant. The cells most affected are nerve cells in the brain and muscle as they require a lot of energy. The symptoms of mitochondrial myopathy include: Muscle weakness (including respiratory muscle) or exer...

It is well known that traumatic brain injury (TBI) increases the body’s metabolic response.1,2 This increased metabolic response leads to hyperglycemia, protein wasting and an increased energy demand, thus adequate nutrition support is vital for recovery.2-4 Adequate nutrition has been a clinical challenge for decades as poor feed tolerance; due to increased gastric resi...

THE PEPTAMEN® FAMILY IS SUPPORTED BY OVER 50 PUBLICATIONS. WE HAVE SELECTED FOUR KEY SUPPORTING EVIDENTIAL PIECES, SPECIFICALLY FOR PAEDIATRICS TO SHARE WITH YOU IN DETAIL, AS WELL AS HIGHLIGHTS FROM OUR RANGE OF CLINICAL EVIDENCE.

A patient with complex feeding issues could not gain weight or reduce the episodes of vomiting, despite trying numerous feeds, until Peptamen® Junior Advance was initiated. Thereafter, his symptoms improved and his family reported improvements in his daily quality of life. Introduction. Patient X is a 4 year old boy who is exclusively gastrostomy fed. He has been under th...

This case study presents a four year old child, newly diagnosed with acute lymphoblastic leukaemia (ALL), who experienced significant intolerance to feeds as a result of his intense treatment regimen, largely chemotherapy. ALL is a cancer of the blood. It is the most common cancer in children, accounting for around one third of cases. Five hundred children are diagnose...

This case study presents a child with severe neurodisabilities and gastrointestinal disease. Many children with cerebral palsy require enteral feeding to ensure adequate nutritional intake to meet nutritional requirements for growth and development, due to aspiration risk with oral intake due to dysphagia and/or gastro-oesophageal reflux disease.1 Hirschsprung’s disea...

A child (Child M) born premature at 33 weeks and 4 days with a complex secondary diagnosis that included GORD, failure to thrive, IUGR, vitamin D resistant rickets, abnormal vocal cords and chronic lung disease. All of which resulted in the need for increased nutritional requirements. This case study discusses the different feeds that were used to manage the complex feeding ...

Crohn’s disease (CD) is a chronic inflammatory bowel disease characterised by patchy, transmural inflammation and ulceration affecting anywhere in the gastrointestinal tract with ileocolonic disease being the most frequent presentation.1 While the exact cause of CD is not known, it is thought to result from a complex interplay between intestinal bacteria and environmenta...

Crohn’s disease (CD) is a chronic inflammatory bowel disease characterised by patchy, transmural inflammation and ulceration affecting anywhere in the gastrointestinal tract with ileocolonic disease being the most frequent presentation.1 While the exact cause of CD is not known, it is thought to result from a complex interplay between intestinal bacteria and environmenta...

This following shows a non-extensive list of the key clinical evidence behind Modulen® IBD. You will find a chronological summary of all the data collected and published over recent years that demonstrate the safety and efficacy of this product in Crohn’s Disease. Modulen® IBD is the only enteral product with extensive clinical evidence in Crohn’s Disease. All these studies have great...

The Optifast welcome pack gives you all the information you need about our Optifast products as well as usage instructions and a step by step guide on how to place an order. The Optifast range provides a selection of tasty products that have been developed specifically for medically-supervised weight loss. Why Optifast? - Nutritionally Complete & Balanced - Medically endorsed - Clinically Proven - Hassle free product ordering

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...

The Nestlé Health Science dysphagia team have proudly partnered with independent Speech and Language Therapist Sandra Robinson and Research Outreach to create an informative article: Thickeners, the evidence for their appropriate use in dysphagia management. The research article explores the different ways in which dysphagia can affect an individual’s quality of life through physica...

The Clinical Nutrition Highlights newsletters will provide a structured compilation of the most relevant nutritional clinical guidelines and recently published articles on how to manage nutritional issues related to COVID-19. The objectives are to: Help identify the key recommendations among the large amounts of data generated on COVID-19. To provide HCPs with an easy read ...

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..."

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.

Nutrition and Hydration week is designed to highlight the importance of adequate hydration and nutrition and how to support patients in achieving this. Poor hydration and nutrition are common complications of dysphagia. We have collated this A4 poster pack to support you in improving the nutrition and hydration status of dysphagia patients.

A summary of clinical studies on the effect of PHGG on gastrointestinal symptoms and bowel function.

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.

A helpful poster to support Nurses with identifying the ‘red flags of malnutrition’ in their patients.

A succinct view of the 2021 ESPEN practical guidelines.

A helpful reminder for all healthcare professionals, this MNI poster captures the challenges posed by malnutrition in cancer patients. The benefits of good nutritional care and the important role of dietitians are highlighted.

WHAT MAKES AN EFFECTIVE SPECIALIST CMA FORMULA? Very few eHFs and AAFs have been shown effective, both in terms of allergy and growth.6,7 At Nestlé Health Science, we set the highest standards for our CMA formulas, SMA® Althéra® and SMA® Alfamino®, ensuring both manufacturing excellence and robust clinical evidence to demonstrate: Proven hypoallergenicity  According to guidelines, the gold standard is for hypoallergenic formulas to be tolerated by at least 90% of infants with proven CMA (with 95% confidence interval) in a clinical trial.1,3,6  Growth and development  According to guidelines, the gold standard is for hypoallergenic formulas to demonstrate normal growth in a clinical trial, because whilst eHF and AAF nutritional profiles are governed by strict regulations,7,8 there are still significant compositional differences between brands.5 REFERENCES: 1. Luyt D et al. Clin Exp Allergy 2014; 44: 642–672. 2. Grimshaw K et al. Clin Transl Allergy 2016; 6: 1. 3. Koletzko S et al. JPGN 2012; 55(2): 221–229. 4. Muraro A et al. Allergy 2014; 69(5): 590–601. 5. Meyer R et al. EMJ Allergy and Immunol. 2017; 2(1): 46–51. 6. Chauveau, A. et al. Pediatr Allergy Immunol. 2016; 27(5): 541–543.   7. Commission Delegated regulation (EU) 2016/128. 8. Commission directive 1999/21/EC

Download Score card The CoMiSSTM score ranges from 0 to 33. Each symptom has a maximal score of six, with the exception of respiratory symptoms (maximal score of three). An arbitrary cut-off value of ≥10 was selected as the criterion to pick up infants at risk of CMA. A score of 10 requires the presence of at least two severe symptoms and a score higher than 10 requires the presence of at least three symptoms and the involvement of two organ systems. Published data using the CoMiSS in clinical trials show that the predictive value of the tool is 80% if the score is >10 at the start and decreases to < 6 within 2 weeks under an elimination diet with an extensiviley hydrolysed formula. To access the full content and download the brochure, register now.

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.

Are you looking to cook with confidence for your dysphagia patients? We have teamed up with Dysphagia Chef Gary Brailsford to create the ultimate guide of golden rules that will have you cooking with confidence for patients on IDDSI levels 4, 5 and 6.  

A classic recipe for fish lovers, this texture modified Fish Pie recipe is perfect for a hearty lunch or dinner. Suitable for IDDSI level 5 dysphagia patients, Chef Gary provides a step-by-step guide to help you create the perfect pie!

A wholesome vegetarian option or simply a great meal for those who love beans, this optionally spicy stew is a great choice for IDDSI level 4 dysphagia patients who are looking for a more adventurous lunch or dinner.

A flavoursome meaty option for meatball and sausage fans, this Pork and Chorizo Meatballs recipe is great lunch or dinner choice. Suitable for IDDSI level 5 dysphagia patients.

A lovely fruity dessert perfect any time of year, this recipe by Chef Gary, provides a step-by-step guide on how to prepare rhubarb and ginger fool for dysphagia patients on IDDSI levels 4, 5 and 6.

A national favourite and timeless British dish, this textured modified diet sausage, mash and beans recipe is a great option for IDDSI level 4 dysphagia patients looking for a classis British meal.

A hearty winter option, the sweet potato, cauliflower and lentil goulash recipe is a great vegetarian choice for IDDSI level 6 dysphagia patients.

Perfect for fans of classic Chinese food, this recipe is suitable for IDDSI level 5 dysphagia patients who are vegetarian, vegan or just looking for something a little more adventurous for tea!

A fragrant Indian vegetable curry, this recipe is perfect for IDDSI level 6 dysphagia patients looking for a meal with a little bit of spice in it.

A creamy vegetable recipe, packed full of root vegetables and perfect for those colder nights, the vegetable stroganoff recipe is suitable for vegetarians and dysphagia patients on IDDSI level 6.

A great option to up protein levels on a pasta dish, this Bolognese sauce recipe is suitable for IDDSI level 5 dysphagia patients.

A lovely recipe choice for a heart-warming soup, this broccoli and stilton soup recipe is suitable for IDDSI level 4 dysphagia patients.

Chef Gary’s take on the traditional cauliflower cheese, this cauliflower and broccoli cheese recipe adds some additional colour and is suitable for IDDSI level 6 dysphagia patients.

A great go to for special occasions, the celebration cake recipe offers a step-by step guide on how create this sweet treat and is suitable for IDDSI level 4, 5 and 6 dysphagia patients.

An indulgent fruit and chocolate dessert for those with a sweet tooth, this chocolate and pear custard recipe is suitable for dysphagia patients on IDDSI levels 4, 5 and 6.

A classic meat and potato pie, this cottage pie recipe is suitable for IDDSI level 4 dysphagia patients.

For the festive season, Chef Gary offers a simple step by step guide to create a delicious 3 course meal for texture modified diet patients, that is perfect for this time of year. Take away the hassle and stress of eating for dysphagia patients with these IDDSI 4, 5 and 6 compatible recipes.

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.