Feeding dysfunction in infants with severe chronic renal failure after long-term nasogastric tube feeding.
Nasogastric tube feeding (NGTF) is frequently necessary to overcome the inadequate caloric intake of children with severe chronic renal failure (CRF). In a multicenter retrospective study, we evaluated feeding dysfunction after tube feeding withdrawal in children with severe CRF who started long-term enteral nutrition early in childhood. We considered, almost exclusively, infants who had started NGTF very early and continued to be tube fed for at least 9 months. Twelve patients were included in the study: 8 showed significant and persistent eating difficulties, with difficulties in chewing and swallowing in 7 and food refusal in 6. For 2 patients "panic attacks" from swallowing were repeatedly reported. These problems persisted for more than year in 5 patients and between 1 and 6 months in 4. The possible feeding difficulties that may follow NTGF must be carefully evaluated. A possible means of overcoming these difficulties might include: encouraging the use of a pacifier, proposing water for spontaneous assumption, leaving the child the possibility of eating food spontaneously during the daytime, and increased support for the parents during weaning. These need prospective study.
Dello Strologo
L
L
Division of Nephrology and Dialysis, Bambino Gesù Children's Research Hospital, Rome, Italy.
Principato
F
F
Sinibaldi
D
D
Appiani
A C
AC
Terzi
F
F
Dartois
A M
AM
Rizzoni
G
G
D002675:Child, Preschool; D003679:Deglutition; D002149:Energy Intake; D004750:Enteral Nutrition / Q000009:adverse effects*; D001068:Feeding and Eating Disorders / Q000209:etiology* / Q000523:psychology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D012189:Retrospective Studies