FEEDING CHALLENGES IN PEDIATRIC INTESTINAL FAILURE: INSIGHTS FROM THREE DIFFERENT INSTRUMENTS.

Background

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Aims

Feeding difficulties are frequently reported in children with intestinal failure (IF) and may represent an important barrier to transition from parenteral nutrition (PN) to enteral autonomy. Appropriate assessment tools are essential for accurate recognition and management of feeding challenges. The objective was to evaluate feeding difficulties using three complementary assessment instruments in children with IF receiving prolonged PN.

Methods

This cross-sectional study included children aged 6 months to 18 years with IF receiving PN for more than two months. Children with oropharyngeal dysphagia, severe neurological disease and severe congenital disorders were excluded. Caregivers completed a structured interview, and three instruments were applied: American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA-NOMS), Montreal Children's Hospital Feeding Scale (MCH-FS), and Schedule for Oral Motor Assessment (SOMA). Cutoff points were defined according to instrument psychometric properties. Results were analyzed by age groups.

Results

Fifty-one patients were evaluated (median age 31.8 months, IQR 16.1-58.2; 62.7% male). Feeding abnormalities identified by at least one instrument were present in 52.9% of participants. Abnormalities were detected in 31.4% by MCH-FS and ASHA-NOMS, and 23.5% by SOMA, which identified a significantly higher frequency of abnormalities in children younger than 36 months.

Conclusion

More than half of children with IF receiving prolonged PN showed feeding abnormalities. Combined tools may improve identification of feeding difficulties and guide individualized interventions.