Home Nasogastric Feeds: Feeding Status and Growth Outcomes in a Pediatric Population

JPEN J Parenter Enteral Nutr. 2016 Mar;40(3):350-4. doi: 10.1177/0148607114551967. Epub 2014 Sep 26.

Abstract

Background: Home enteral nutrition (HEN) is a safe method for providing nutrition to children with chronic diseases. Advantages of HEN include shorter hospitalizations, lower cost, and decreased risk of malnutrition-associated complications. Follow-up after hospital discharge on HEN is limited. The purpose of this study was to look at children discharged on nasogastric (NG) feeds to assess follow-up feeding status and impact on growth.

Methods: A retrospective chart review was conducted of pediatric patients discharged from Mount Sinai Medical Center on NG feeds between January 2010 and March 2013.

Results: A total of 87 patients were included. Average age was 1.2 years. The most common diagnoses were congenital heart disease (47%), metabolic disease (17%), neurologic impairment (10%), liver disease (9%), prematurity (8%), and inflammatory bowel disease (6%). At most recent follow-up, 44 (50.6%) were on full oral feeds, 8 (9.2%) were still on NG feeds, 9 (10.3%) had a gastrostomy tube placed, 9 (10.3%) were deceased, and 17 (19.5%) had transferred care or were lost to follow-up. Average time to discontinuation of NG feeds was 4.8 months. Change in body mass index from hospital discharge to follow-up visit 6 to 12 weeks after discharge was statistically significant, from a mean (SD) of 13.78 (2.82) to 14.58 (2.1) (P = .02). Change in weight z score was significant for neurologic impairment (-1.35 to -0.04; P = .03). Height z score change was significant for prematurity (-3.84 to -3.34; P = .02). There was no significant change in height or weight z scores for the other diagnoses.

Conclusions: NG feeds can help to improve short-term growth after hospital discharge in children with chronic illnesses.

Keywords: enteral nutrition; home nutrition support; pediatrics.

MeSH terms

  • Adolescent
  • Body Mass Index
  • Body Weight
  • Child
  • Child, Preschool
  • Chronic Disease
  • Enteral Nutrition / methods*
  • Female
  • Follow-Up Studies
  • Heart Defects, Congenital / therapy
  • Humans
  • Infant
  • Infant, Premature / growth & development
  • Inflammatory Bowel Diseases / therapy
  • Intubation, Gastrointestinal*
  • Liver Diseases / therapy
  • Male
  • Metabolic Diseases / therapy
  • Nervous System Diseases / therapy
  • Patient Discharge*
  • Retrospective Studies
  • Treatment Outcome