Home Enteral Feeding of Children in the West of Scotland

Abstract

Home enteral feeding (HEF) is increasingly used to achieve positive energy and nitrogen balance in children with chrpnic disease outside hospital. It should be considered when oral feeding cannot or should not be used, and when nutritional support is the sole reason for hospitalisation. In the West of Scotland 156 children (80 male, 76 female) cared for by the Royal Hospital for Sick Children in Glasgow received HEF between 1st September 1994 and 1995. They ranged in age from 0 months to 23 years. Indications for HEF were cystic fibrosis (21), cerebral palsy (17), other neurological disease (29), congenital/metabolic abnormalities (23), chronic renal failure (17), neoplastic disease (17), gastrointestinal/hepatic disease (12), failure-to-thrive (10), and cardiorespiratory disease (10). Most children received feeds by nasogastric tube (59%) or gastrostomy (41%). One child had a jejunostomy. Feeding regimens were continuous infusion (52%), bolus feeding alone (26%), and a combination of bolus and infusion (22%). 73% of patients had infusion pumps. Duration of HEF ranged from one month to 12 years. 78% of children received standard infant or enteralfeeds, some receiving energy supplements. The remainder received ‘disease-specific’ or other special feeds. There was a 23% increase in the number of children receiving HEF during the year of the study. HEF represents an effective way of improving the nutritional status of children with chronic disease at home. It frees hospital beds and nursing resources, is well accepted by children and their families and is growing rapidly as an alternative to hospitalisation.