title: Feeding dysfunction in infants with severe chronic renal failure after long-term nasogastric tube feeding.
abstract: 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.
authors.affiliation: Division of Nephrology and Dialysis, Bambino Gesù Children's Research Hospital, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Dello Strologo
authors.forename: F
authors.initials: F
authors.lastname: Principato
authors.forename: D
authors.initials: D
authors.lastname: Sinibaldi
authors.forename: A C
authors.initials: AC
authors.lastname: Appiani
authors.forename: F
authors.initials: F
authors.lastname: Terzi
authors.forename: A M
authors.initials: AM
authors.lastname: Dartois
authors.forename: G
authors.initials: G
authors.lastname: Rizzoni
mesh_terms: 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