Formula Switch Leads to Enteral Feeding Tolerance Improvements in Children With Developmental Delays
Gerard Minor, Juan B Ochoa, Heidi Storm, Seletha Periman, Gerard Minor, Juan B Ochoa, Heidi Storm, Seletha Periman
Abstract
Background: Children with developmental delays are often dependent on enteral nutrition. The aim of our study was to evaluate improvement in tolerance parameters in these children who were switched from an intact protein formula to a 100% whey, peptide-based formula. Methods: A retrospective chart review of children with developmental delays who were failing to reach adequate nutritional goals on standard polymeric formulas were switched to a 100% whey peptide-based formula. Enteral volume goals, caloric goals, and change in medication used to improve feeding tolerance were assessed before and after formula switch. Results: Medical records of 13 children (aged 8.4 ± 4.6 years) met criteria. All children had a primary diagnosis of developmental delay, and 77% were fed via gastrostomy tube. Of the 13 children assessed, 92% experienced improved feeding tolerance, and 75% of these reported the time to improvement within 1 week after formula switch. Feeding tolerance parameters that improved were vomiting (86%), gagging and retching (75%), high residual volumes (63%), constipation (43%), diarrhea (100%), and poor weight gain (100%). Conclusion: Switching to a 100% whey, peptide-based formula improved symptoms of feeding intolerance in the majority of these developmentally delayed children.
Keywords: developmental delay; enteral nutrition; peptide.
Conflict of interest statement
Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Ochoa and Ms Periman are employees of Nestle Health Science in Florham Park, NJ. Ms Storm was employed at Nestle Health Science in Florham Park, NJ, at time of study completion and is now employed at Nestle Nutrition in Florham Park, NJ.
Figures
References
- Sullivan PB, Juszczak E, Bachlet AM, et al. Gastrostomy tube feeding in children with cerebral palsy: a prospective, longitudinal study. Dev Med Child Neurol. 2005;47:77-85.
- Sullivan PB, Lambert B, Rose M, Ford-Adams M, Johnson A, Griffiths P. Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford Feeding Study. Dev Med Child Neurol. 2000;42:674-680.
- Savage K, Kritas S, Schwarzer A, Davidson G, Omari T. Whey- vs casein-based enteral formula and gastrointestinal function in children with cerebral palsy. JPEN J Parenter Enteral Nutr. 2012;36(1 suppl):118S-123S. doi:110.1177/0148607111428139.
- Chong SK. Gastrointestinal problems in the handicapped child. Curr Opin Pediatr. 2001;13:441-446.
- Marchand V. ed. Pediatric Nutrition Support Handbook. Burlington, MA: Bartlett; 2007.
- Del Giudice E, Staiano A, Capano G, et al. Gastrointestinal manifestations in children with cerebral palsy. Brain Dev. 1999;21:307-311.
- Fried MD, Khoshoo V, Secker DJ, Gilday DL, Ash JM, Pencharz PB. Decrease in gastric emptying time and episodes of regurgitation in children with spastic quadriplegia fed a whey-based formula. J Pediatr. 1992;120:569-572.
- Graham-Parker C, Prokopishin L, Storm H, Van Aerde J. Effect of whey-based diet on incidence of vomiting in G-tube fed children with severe neurodevelopmental delay. Paper presented at: American Society of Parenteral and Enteral Nutrition Meeting; 2001. (Abstract 0051)
- Khoshoo V, Brown S. Gastric emptying of two whey-based formulas of different energy density and its clinical implication in children with volume intolerance. Eur J Clin Nutr. 2002;56:656-658.
- Chaidez V, Hansen RL, Hertz-Picciotto I. Gastrointestinal problems in children with autism, developmental delays or typical development. J Autism Dev Disord. 2014;44:1117-1127.
Source: PubMed