Fascicolo monotematico "La Nutrizione Artificiale"
From breast milk to blenderized foods: how to feed the baby in enteral nutrition?
Domenica Elia, Daniela Marino, Anna Maria Cappelli, Francesca Romano
1U.O. Nutrizione Artificiale, Ospedale Pediatrico Bambino Gesù, Roma
The choice of enteral nutrition for infants, children and adolescents must be founded on a careful evaluation of the caloric, nutrient and electrolyte needs, and based on the following criteria: patient’s age and type of pathology, presence of food allergy or intolerance and mode or route of administration (through SNG or PEG or PEJ). Standard enteral formulas meet macro- and micronutrient needs; therapeutic enteral formulas contain also specific pharmaconutrients that may attenuate hyperinflammatory responses, enhance the immune responses to infection, or improve gastrointestinal tolerance. Polymeric formulas are useful in patients with integrity of the gastrointestinal tract. The use of semi-elemental formulas is indicated in children with compromised GI function and in case of post-pyloric enteral administration. Elementary formulas are indicated only in cases of severe allergy, not responding to extensive hydrolyzates formulas. Clinicians must carefully consider different use of specialty formulas, paying close attention to the quality, patient population, clinical end points, cost and/or facility of administration for patients.