Journal
BONE MARROW TRANSPLANTATION
Volume 27, Issue 7, Pages 741-746Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/sj.bmt.1702855
Keywords
enteral feeding; children; BMT
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This study retrospectively analyses the experience with an intensive enteral feeding protocol in children undergoing BMT at the National Paediatric BMT Centre, Our Lady's Hospital for Sick Children, Crumlin, Dublin. Fifty-three patients were transplanted between January 1996 and December 1998; 42 patients received allogeneic transplants, (19 unrelated) and II were autologous, Indications included ALL (21), ANLL (3), CML (3), JCML (1), MPS (5), WAS (2), AA/FA (6), NHL/HD (3) and solid tumours (9), Nasogastric (NG) tubes were inserted electively either during conditioning or within the first week when voluntary oral intake had decreased. Nineteen patients were commenced on a whole protein-based formula, 28 on a semi-elemental preparation and two were commenced on an elemental feed, All were maintained on an elemental formula during the period of maximal gut toxicity,Tubes which were vomited were promptly replaced and morphine infusions were routinely employed until mucositis had resolved, Of 49 evaluable patients, 42 (86%) were maintained exclusively on enteral nutrition and seven required parenteral nutrition. Seven patients weighed < 85% ideal body weight (IBW) at discharge (range 75-84), only one of whom was < 85% IBW at 3 months, Twenty-two patients continued on NG feeds following discharge (median 41 days). No patient had veno-occlusive disease. The programme was overwhelmingly endorsed by patients and/or parents but required intensive multidisciplinary counselling to ensure success.
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