Children with an underlying disease or condition at greatest risk of faltering growth include those with neuro-disabilities e.g. cerebral palsy, congenital heart defects, cystic fibrosis, liver disease, gastrointestinal disease or cancer.1,2 These conditions may decrease nutrient intake for a number of reasons, for example by causing feeding and/or swallowing difficulties; affected children may also have increased nutritional needs and/or increased nutritional losses. As a result, children with these conditions may become undernourished if adequate nutritional support is not provided.3
The importance of nutritional support
In children with (or at risk of) disease-related faltering growth, it is essential that adequate nutritional support is initiated by healthcare professionals as early as possible. The goal of nutritional support in paediatric patients is to provide adequate amounts of energy, protein and micronutrients for optimal growth and development, and preservation of lean tissue mass and body composition, while minimising gastrointestinal symptoms, supporting developmentally appropriate feeding behaviour and enhancing quality of life.
There is no single nutritional therapy that is applicable for all children. The type of nutritional intervention depends on the age, clinical situation, absorptive and digestive capacity, oral intake, and tolerance of the child, as well as on feasibility. Possible nutritional therapies include dietary advice and counselling, oral supplements, enteral tube feeding and parenteral nutrition. Special feeds are required for children because adult formulas contain too much protein and an inappropriate vitamin and mineral profile to meet their nutritional needs. In other words, the composition of paediatric feeds should be age adapted.3