Article

Limited effect of enteral nutrition on growth in a group of children with severe developmental disabilities

Authors:
  • Azienda Unità Sanitaria Locale della Romagna - Forlì, Italy
  • Azienda Sanitaria Unica Regionale Marche - AV3 - Ospedale Generale Provinciale Macerata
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Abstract

Objectives. A group of children with severe neurological diseases, on home enteral nutrition, was evaluated to assess the modifications of growth variables during the first year of nutritional intervention. Methods. Nineteen patients were studied. The following variables were recorded at the start (T0) and after 12 months (T12) of enteral nutrition: age, weight and length (z-score), percentage of ideal weight for length, type of enteral feeding, actual and recommended energy intake for age and weight. Results. Median age at the start of enteral nutrition was 7.5 (range 0-16.6) years. At T0, mean (SD) values for weight and length z-score and percent weight for length were -5.7 (5.9), -3.2 (2) and 84% (18) respectively. No significant modifications were noted for weight and length z-score after 12 months of enteral nutrition. At the same time, percent weight for length significantly increased [mean difference (95% CI): 6.9% (0.3; 13.5); p = 0.04] in the group studied. Weight z-score was significantly related (r = -0.73, p < 0.001) with age at T0, while no relationship was observed for length z-score and percent weight for length. Mean (SD) ratio between actual energy intakes and those recommended for age was 0.77 (0.37) at T0 and 0.65 (0.37) at T12. Conclusions. In severely disabled children, enteral nutrition caused limited modifications of growth variables during the first year of nutritional support. Determinants other than malnutrition alone may have a role in growth failure in such patients. Both growth charts and recommended energy intakes for healthy children may be unreliable standards in this clinical context.

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