[en] [en] BACKGROUND: Enteral nutrition is necessary when nutritional status is poor and oral intake is insufficient or impossible. Although it has been suspected to reduce spontaneous oral feeding, no study has formally assessed the influence of enteral nutrition on pediatric oral intake. The present study aimed to evaluate variation in oral feeding intake after enteral nutrition initiation, and to identify factors influencing oral feeding.
METHODS: This retrospective cohort study included 149 pediatric patients from two French tertiary care hospitals, who received home enteral nutrition from 2009 to 2022. The patients were aged 2 months to 17 years (median age 3 years, interquartile range 1.3-9.2). Oral and enteral intakes were assessed when enteral nutrition was initiated (M0), and again at M3 (n = 123), M6 (n = 129), and M12 (n = 134) follow-ups, based on dieticians' and home services' reports. Oral feeding and body mass index z score variations during follow-ups were evaluated using a linear mixed regression model, including "time" as a fixed effect and "patient" as a random effect. Factors associated with oral feeding changes were assessed using a model interaction term.
RESULTS: Oral intake did not vary significantly (P = 0.99) over time and accounted for 47.4% ± 27.4%, 46.9% ± 27.4%, 48.4% ± 28.2%, and 46.6% ± 26.9% of the ideal recommended daily allowance (calculated for the ideal weight for height) at M0, M3, M6, and M12, respectively. Delivery method (nasogastric tube versus gastrostomy), prematurity, underlying disease, history of intrauterine growth retardation, and speech therapy intervention did not influence oral intake. Administration (i.e., exclusively continuous nocturnal infusion versus daytime bolus) led to different oral intake development, although oral intake also differed at M0.
CONCLUSIONS: Enteral nutrition, although increasing total energy intake, does not alter oral feeding during the first year of administration. Only the mode of administration might influence oral intake.
Disciplines :
Pediatrics Gastroenterology & hepatology
Author, co-author :
ZAMBELLI, Laura ; Centre Hospitalier Universitaire de Liège - CHU > > Service de pédiatrie
Aumar, M ; Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France. Electronic address: madeleine.aumar@chu-lille.fr
Ley, D; Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France. Electronic address: delphine.ley@chu-lille.fr
Antoine, M ; Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France. Electronic address: matthieu.antoine@chu-lille.fr
Coopman, S ; Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France. Electronic address: stephanie.degryse@chu-lille.fr
Morcel, J ; Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France. Electronic address: jules.morcel.etu@univ-lille.fr
Bequet, Emeline ; Université de Liège - ULiège > Département des sciences cliniques > Médecine générale
Guimber, D; Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France. Electronic address: dominique.guimber@chu-lille.fr
Cailliau, E ; Biostatistics Department, CHU Lille, F-59000 Lille, France. Electronic address: emeline1.cailliau@chu-lille.fr
Peretti, N ; Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Hospices Civils de Lyon, Lyon, France. Electronic address: noel.peretti@chu-lyon.fr
Gottrand, F; Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France. Electronic address: frederic.gottrand@chu-lille.fr
Language :
English
Title :
Home enteral nutrition does not decrease oral feeding in children during the first year of nutritional support.
Braegger, C., Decsi, T., Dias, J., Hartman, C., Kolaček, S., Koletzko, B., et al. Practical approach to paediatric enteral nutrition: a comment by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr 51:1 (2010), 110–122.
Romano, C., van Wynckel, M., Hulst, J., Broekaert, I., Bronsky, J., Dall'Oglio, L., et al. European society for paediatric gastroenterology, hepatology and nutrition guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with neurological impairment. J Pediatr Gastroenterol Nutr 65:2 (2017), 242–264.
Diamanti, A., Di Ciommo, V.M., Tentolini, A., Lezo, A., Spagnuolo, M.I., Campanozzi, A., et al. Home enteral nutrition in children: a 14-year multicenter survey. Eur J Clin Nutr 67:1 (2013), 53–57.
Goday, P.S., Huh, S.Y., Silverman, A., Lukens, C.T., Dodrill, P., Cohen, S.S., et al. Pediatric feeding disorder: consensus definition and conceptual framework. J Pediatr Gastroenterol Nutr 68:1 (2019), 124–129.
Rommel, N., De Meyer, A.M., Feenstra, L., et, Veereman-Wauters, G., The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution. J Pediatr Gastroenterol Nutr 37:1 (2003), 75–84.
Martínez-Costa, C., Calderón, C., Gómez-López, L., Borraz, S., Crehuá-Gaudiza, E., et, et al. Nutritional outcome in home gastrostomy-fed children with chronic diseases. Nutrients, 11(5), 2019, 956.
Dipasquale, V., Lecoeur, K., Aumar, M., Guimber, D., Coopman, S., Nicolas, A., et al. Factors associated with success and failure of weaning children from prolonged enteral nutrition: a retrospective cohort study. J Pediatr Gastroenterol Nutr 72:1 (2021), 135–140.
Edwards, S., Davis, A.M., Bruce, A., Mousa, H., Lyman, B., Cocjin, J., et al. Caring for tube-fed children: a review of management, tube weaning, and emotional considerations. J Parenter Enteral Nutr 40:5 (2016), 616–622.
Petersen, M.C., Kedia, S., Davis, P., Newman, L., et, Temple, C., Eating and feeding are not the same: caregivers' perceptions of gastrostomy feeding for children with cerebral palsy. Dev Med Child Neurol 48:9 (2006), 713–717.
Heude, B., Scherdel, P., Werner, A., Guern, M.L., Gelbert, N., Walther, D., et al. A big-data approach to producing descriptive anthropometric references: a feasibility and validation study of paediatric growth charts. The Lancet Digital Health 1:8 (2019), e413–e423.
Martin, A., Apports nutritionnels conseillés pour la population française. 2000.
Body mass inder-for-age (BMI-for-age), WHO. accessed April 2023 https://www.who.int/toolkits/child-growth-standards/standards/body-mass-index-for-age-bmi-for-age.
Mason, S., Harris, G., et, Blissett, J., Tube feeding in infancy : implications for the developmentof normal eating and drinking skills. Dysphagia 20:1 (2005), 46–61.
Pahsini, K., Marinschek, S., Khan, Z., Dunitz-Scheer, M., et, Scheer, P.J., Unintended adverse effects of enteral nutrition support: parental perspective. J Pediatr Gastroenterol Nutr 62:1 (2016), 169–173.
Stratton, R.J., Stubbs, R.J., et, Elia, M., Short-term continuous enteral tube feeding schedules did not suppress appetite and food intake in healthy men in a placebo-controlled trial. J Nutr 133:8 (2003), 2570–2576.
Blundell, J., de Graaf, C., Hulshof, T., Jebb, S., Livingstone, B., Lluch, A., et al. Appetite control: methodological aspects of the evaluation of foods. Obes Rev: Off J Inter Assoc Stud Obes 11:3 (2010), 251–270.
Stratton, J., The impact of nutritional support on appetite and food intake. Clin Nutr 20:Supplement 1 (2001), 147–152.
Saunders, J., et, Smith, T., Malnutrition: causes and consequences. Clin Med 10:6 (2010), 624–627.
Martínez-Costa, C., Borraz, S., Benlloch, C., López-Sáiz, A., Sanchiz, V., et, et al. Early decision of gastrostomy tube insertion in children with severe developmental disability: a current dilemma. J Hum Nutr Diet: Off J Br Diet Assoc 24:2 (2011), 115–121.
Dipasquale, V., Cucinotta, U., Alibrandi, A., Laganà, F., Ramistella, V., et, et al. Early tube feeding improves nutritional outcomes in children with neurological disabilities: a retrospective cohort study. Nutrients, 15, 2023, 2875.
Gonzalez, J.T., Dirks, M.L., Holwerda, A.M., Kouw, I.W.K., et, Van Loon, L.J.C., Intermittent versus continuous enteral nutrition attenuates increases in insulin and leptin during short-term bed rest. Eur J Appl Physiol(9), 2020, 2083–2094 Vols. %1 sur %2120.
Heuschkel, R., Gottrand, F., Devarajan, K., Poole, H., Callan, J., Dias, J., et al. ESPGHAN position paper on management of percutaneous endoscopic gastrostomy in children and adolescents. JPGN, 60(1), 2015.
Abdelhadi, R.A., Rempel, G., Sevilla, W., Turner, J.M., Quet, J., Nelson, A., et al. Transitioning from nasogastric feeding tube to gastrostomy tube in pediatric patients: a survey on decision-making and practice. Nutr Clin Pract 36:3 (2021), 654–664.