The impact of fibre and prebiotic interventions on outcomes in cancer and haematopoietic stem cell transplantation: A systematic review.

Background & Aims: Cancer therapy is associated with a range of toxicities that severely impact patient well-being and a range of clinical outcomes. Dietary fibre/prebiotics characteristically improve the gastrointestinal microenvironment, which consequently elicits beneficial downstream effects that could be relevant to the prevention and management of treatment-related toxicities. Despite the compelling theoretical scientific rationale there has been limited effort to synthesise the available evidence to conclude such scientific underpinning to the clinical use of fibre/prebiotics in cancer patients.

The impact of an enteral formula with food-derived ingredients on dietetic practice at a specialist children's hospital in the UK: Retrospective study.

Background: Blended tube feeds are reported to be better tolerated in some children compared to standard commercial enteral formulas, allowing children to normalise feeding by having similar foods as the rest of the family. However, a blended tube feed is contraindicated in patients who are immunocompromised or require post-pyloric feeding as a result of a food safety risk. Other contraindications for blended diet include children who require continuous pump feeding via gastrostomy or nasogastric feeding tube (< 12 Fr) and fluid restrictions.

The impact of low-energy, partially hydrolysed enteral formula on gastrointestinal symptoms and weight in children with neurological impairment: a multicentre retrospective study.

Background: Neurological impairment (NI) relates to disorders of the central nervous system. The specific aetiology of NI varies but includes genetic, congenital abnormalities or brain injury. In children with severe NI, feeding impairments can lead to undernutrition, and some children require a feeding tube.

Exploring near death experiences with children post intensive care: A case series.

Near death experiences (NDEs) can occur during life-threatening events. In this article, we present preliminary findings from a case study series. We highlight experiences of children that are synchronous with the basic elements of near death experiences (NDEs) and discuss how children describe their own experiences.

Complications and outcomes of gastrostomy versus nasogastric tube feeding in paediatric allogeneic bone marrow transplant: A prospective cohort study.

Background & Aims: The intensive conditioning regimens administered during bone marrow transplant (BMT) frequently cause mucositis, gastrointestinal toxicity and reduced oral intake. Children are consequently at risk of malnutrition. First-line nutrition support is recommended as enteral nutrition (EN).

Intermittent bolus versus continuous feeding in children receiving an enteral formula with food derived ingredients: A national multicentre retrospective study.

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 Cross-sectional Survey to Review Food Safety Practices Within Pediatric Oncology and Stem Cell Transplant Centers in the United Kingdom.

Food Safety And Pediatric Cancer: Neutropenia is a common complication of chemotherapy, which poses a high risk of infection and mortality. Neutropenic diet has historically been recommended for those undergoing chemotherapy. The rationale is to reduce the risk of foodborne infection by avoiding foods considered to be of high microbial risk.

Open-labelled study to monitor the effect of an amino acid formula on symptom management in children with spinal muscular atrophy type I: The SMAAF pilot study.

Background: An increasing number of families with children who have spinal muscular atrophy (SMA) are incorporating a special amino acid diet into their child's feeding regimens. Characteristics of the diet include high-carbohydrate and low-fat content with added probiotics. However, because of insufficient evidenced-based research, clinicians are unable to prescribe or endorse this diet.

Exclusive enteral nutrition practices in the management of Crohn's disease: A cross sectional survey of specialist paediatric dietitians.

Background And Aim: Exclusive enteral nutrition (EEN) is the first line management to induce remission of active Crohn's disease (CD). EEN is well established but there continues to be significant variation in practice especially in relation to what first line formula is used, length of time on EEN, and food reintroduction. The survey aimed to establish dietetic practices in implementing EEN in the management of active CD across specialist paediatric inflammatory bowel disease (IBD) centres.

Research Priorities for Pediatric Intensive Care Nutrition Within the United Kingdom: A National Institute of Health Research James Lind Alliance Priority Setting Partnership.

Objectives: To determine research priorities in PICU nutrition, which represent the shared priorities of patients, parents, carers, and PICU healthcare professionals within the United Kingdom.

Design: A national multiphase priority setting methodology in partnership with the James Lind Alliance delivered over 16 months (June 2020-September 2021). Part 1: a national scoping survey asked respondents to submit their research uncertainties related to PICU nutrition.

Nutritional support practices and opinions toward gastrostomy use in pediatric bone marrow transplant centers: A national survey.

Objective: Previous surveys have shown deviations in nutritional practices from international guidelines during bone marrow transplant (BMT). Guidelines recommend enteral nutrition first-line and nasogastric tubes are the mainstay for its provision. Gastrostomies provide an alternative, yet their use is less common.

Monitor gastrointestinal tolerance in children who have switched to an "enteral formula with food-derived ingredients": A national, multicenter retrospective chart review (RICIMIX study).

Background: Enteral tube feeding intolerances, such as diarrhea, are commonly reported in children. In the pediatric population, interest is growing in the use of blended diets for the management of enteral feeding intolerances. Fiber within a blended diet stimulates the growth of beneficial gut bacteria, which in turn produce short-chain fatty acids, which are utilized as energy substrates for enterocytes.

Systematic review of gastrostomy complications and outcomes in pediatric cancer and bone marrow transplant.

Background: Nutrition support is essential in children with cancer, including those undergoing bone marrow transplant (BMT), to reduce the risk of malnutrition and associated deleterious outcomes. Enteral nutrition is more commonly provided via nasogastric than gastrostomy tubes because of safety concerns with the latter in immunocompromised children. This systematic review investigated the incidence and type of complications and outcomes in pediatric cancer patients fed by gastrostomy.

Faecal calprotectin concentrations in neonates with CHD: pilot study.

Neonates with CHD are at increased risk of developing necrotising enterocolitis due to mesenteric hypoperfusion. Necrotising enterocolitis results in repeated feed interruptions contributing to poor growth during the early post-operative phase. Poor weight gain and longer hospital stay are risk factors for death in neonates with CHD.

Refeeding Low Weight Hospitalized Adolescents With Anorexia Nervosa: A Multicenter Randomized Controlled Trial.

Background: Refeeding patients with anorexia nervosa (AN) is associated with high morbidity and mortality. A lack of evidence from interventional studies has hindered refeeding practice and led to worldwide disparities in management recommendations. In the first randomized controlled trial in this area, we tested the hypothesis that refeeding adolescents with AN with a higher energy intake than what many guidelines recommend improved anthropometric outcomes without adversely affecting cardiac and biochemical markers associated with refeeding.

Hypervitaminosis A is prevalent in children with CKD and contributes to hypercalcemia.

Background: Vitamin A accumulates in renal failure, but the prevalence of hypervitaminosis A in children with predialysis chronic kidney disease (CKD) is not known. Hypervitaminosis A has been associated with hypercalcemia. In this study we compared dietary vitamin A intake with serum retinoid levels and their associations with hypercalcemia.

Refeeding hypophosphatemia in adolescents with anorexia nervosa: a systematic review.

The rate of adolescents presenting with anorexia nervosa (AN) is increasing. Medically unstable adolescents are admitted to the hospital for nutrition restoration. A lack of global consensus on appropriate refeeding practices of malnourished patients has resulted in inconsistent refeeding practices.

The refeeding syndrome and glucose load.

Objective: A 10-year-old girl with anorexia nervosa developed the refeeding syndrome following cautious reintroduction of nutrition, emphasizing that even with cautious refeeding a shift in fluid, glucose, and electrolytes can still occur, increasing the risk of morbidity and mortality in this ever growing vulnerable group.

Method: Biochemical, nutritional, and anthropometrical monitoring in the patient, who followed a conservative refeeding program after a prolonged period of nutritional inadequacy.

Results: The refeeding syndrome presented itself with hypophosphatemia, hypotension, and cardiac abnormalities whilst refeeding at 25 kcal/kg (600 kcal/day).