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.