An observational investigation of the faical microbiota and metabonome of gastrostomy fed children, on blended and formula diets.

Gastrostomy fed children traditionally have a Formulae diet (FD), which fulfills nutritional requirements; however, many families are adopting Blended diets (BD), which are what the whole family would eat. We undertook an observational investigation of the colonic microbiota and metabonome in a small group of gastrostomy fed children, who were either on an FD or BD, and compared, where possible to their siblings (17 FD, 28 BD, 19 HS). There was no increase in complications in tube blockage or infection rates, but a significant improvement in the prevalence of bowel problems, a reduction in medication and an increase in quality of life. Metataxonomic analysis showed that the FD group was significantly different to the Sibling group, and that families did not cluster together. Whole sample metabonomics showed no differences between groups; however, univariate analysis of biologically important metabolites did differ. Changing to a BD resulted in no increase in complications or risks, but improved the overall quality of life for the children and families.

Intestinal failure and long-term parenteral nutrition in children.

Infants and children with intestinal failure such as that seen in short bowel syndrome will require parenteral feeding, some of them in the long-term. Complications of long-term feeding include those associated with central venous catheter use and liver failure associated with parenteral nutrition. Careful monitoring and supportive care from experts in the paediatric nutrition support team are required to ensure that the risks of parenteral nutrition are minimised.

Helping children who require long-term parenteral nutrition.

Parenteral nutrition (PN) is a therapy that is complex and can lead to serious complications such as infection of the central venous catheter. A follow-up audit beginning in 2007 showed that, in a cohort of 36, 16 children were transferred from the neonatal unit and 20 had conditions that might be similar to adult indications for PN. The audit has underlined the fact that the use of PN should be carefully assessed, monitored and discontinued as soon as possible. Intestinal failure is the most common indication for PN and its management requires specific training.