{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:26:34Z","timestamp":1791822394339,"version":"4.3.4"},"reference-count":26,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,6,25]],"date-time":"2023-06-25T00:00:00Z","timestamp":1687651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Nestl\u00e9 Health Science S.A."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Tube feeding is a life-saving treatment for children with neurological disabilities (ND), who often suffer from malnutrition and feeding disorders. Nonetheless, it is still not widely used. Our aim was to evaluate the outcomes of exclusive tube feeding in a cohort of ND children. All consecutive ND children who started tube feeding at our center within the last 5 years were included in this retrospective study. Weight-for-age, body mass index (BMI), mid-upper arm circumference (MUAC) Z-scores, and symptoms were collected at baseline (V0), 6 (V1), and 12 months (V2) after gastrostomy placement. Fifty children (62% males) were included. The ND-underlying disease was genetic (n = 29, 58%), hypoxic-ischemic encephalopathy (n = 17, 34%), or metabolic (n = 4, 8%). Indications for tube feeding were malnutrition (n = 35, 70%), recurrent respiratory infections (n = 11, 22%), or both (n = 4, 8%). Enteral formulae were polymeric (n = 29, 58%), semi-elemental (n = 17, 34%), hypercaloric (n = 3, 6%), or elemental (n = 1, 2%). Homemade blended feed was offered to three children (6%) in addition to the formula. Weight and BMI increased over the study period. Except for constipation, all symptoms (cough, vomiting, and diarrhea) improved at 6 and 12 months (p &lt; 0.05). Non-serious complications (n = 8; track disruption, granuloma, and skin infection) were observed. Longer disease duration (p &lt; 0.001) at the start of tube feeding was associated with the absence of normalization of nutritional status (BMI Z-score &gt; 2 SD) at 12 months. Tube feeding with commercially available enteral formulae should be started as early as possible for better outcomes.<\/jats:p>","DOI":"10.3390\/nu15132875","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T03:14:56Z","timestamp":1687749296000},"page":"2875","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Early Tube Feeding Improves Nutritional Outcomes in Children with Neurological Disabilities: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3328-0734","authenticated-orcid":false,"given":"Valeria","family":"Dipasquale","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood \u201cG. Barresi\u201d, \u201cG. Martino\u201d University Hospital, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0178-9694","authenticated-orcid":false,"given":"Ugo","family":"Cucinotta","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood \u201cG. Barresi\u201d, \u201cG. Martino\u201d University Hospital, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Alibrandi","sequence":"additional","affiliation":[{"name":"Statistical and Mathematical Sciences Unit, Department of Economics, University of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Lagan\u00e0","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood \u201cG. Barresi\u201d, \u201cG. Martino\u201d University Hospital, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Ramistella","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood \u201cG. Barresi\u201d, \u201cG. Martino\u201d University Hospital, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8827-2091","authenticated-orcid":false,"given":"Claudio","family":"Romano","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood \u201cG. Barresi\u201d, \u201cG. Martino\u201d University Hospital, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"977453","DOI":"10.3389\/fpubh.2022.977453","article-title":"Global and regional prevalence of disabilities among children and adolescents: Analysis of findings from global health databases","volume":"10","author":"Olusanya","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.clnu.2019.02.040","article-title":"Nutritional red flags in children with cerebral palsy","volume":"39","author":"Huysentruyt","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Dipasquale, V., Ventimiglia, M., Gramaglia, S.M.C., Parma, B., Funari, C., Selicorni, A., Armano, C., Salvatore, S., and Romano, C. (2019). Health-related quality of life and home enteral nutrition in children with neurological impairment: Report from a multicenter survey. Nutrients, 11.","DOI":"10.3390\/nu11122968"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1093\/infdis\/jis608","article-title":"Childhood tuberculosis and malnutrition","volume":"206","author":"Jaganath","year":"2012","journal-title":"J. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1007\/s00228-022-03374-3","article-title":"Use of ketamine in patients with refractory severe asthma exacerbations: Systematic review of prospective studies","volume":"78","author":"Sanfilippo","year":"2022","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Rytter, M.J., Kolte, L., Briend, A., Friis, H., and Christensen, V.B. (2014). The immune system in children with malnutrition\u2014A systematic review. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0105017"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1097\/MPG.0000000000001646","article-title":"European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with neurological impairment","volume":"65","author":"Romano","year":"2017","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1017\/S0012162205000162","article-title":"Gastrostomy tube feeding in children with cerebral palsy: A prospective, longitudinal study","volume":"47","author":"Sullivan","year":"2005","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_9","unstructured":"Institute of Medicine (2005). Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids, National Academies Press."},{"key":"ref_10","unstructured":"Institute of Medicine (2004). Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate, National Academies Press."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1093\/ptj\/80.10.974","article-title":"Validation of a model of gross motor function for children with cerebral palsy","volume":"80","author":"Palisano","year":"2000","journal-title":"Phys. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/PL00009595","article-title":"The Dysphagia Outcome and Severity Scale","volume":"14","author":"Purdy","year":"1999","journal-title":"Dysphagia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/S0016-5107(99)70222-1","article-title":"Improvement of children\u2019s nutritional status after enteral feeding by PEG: An interim report","volume":"50","author":"Brant","year":"1999","journal-title":"Gastrointest. Endosc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1136\/adc.2005.084442","article-title":"Does gastrostomy tube feeding in children with cerebral palsy increase the risk of respiratory morbidity?","volume":"91","author":"Sullivan","year":"2006","journal-title":"Arch. Dis. Child."},{"key":"ref_15","first-page":"838","article-title":"Intensive nutritional support improves the nutritional status and body composition in severely malnourished children with cerebral palsy","volume":"29","year":"2014","journal-title":"Nutr. Hosp."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Dipasquale, V., Catena, M.A., Cardile, S., and Romano, C. (2018). Standard polymeric formula tube feeding in neurologically impaired children: A five-year retrospective study. Nutrients, 10.","DOI":"10.3390\/nu10060684"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1081139","DOI":"10.3389\/fped.2023.1081139","article-title":"The significance of MUAC z-scores in diagnosing pediatric malnutrition: A scoping review with special emphasis on neurologically disabled children","volume":"11","author":"Kansu","year":"2023","journal-title":"Front. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1111\/dmcn.14857","article-title":"Development of equations and software for estimating weight in children with cerebral palsy","volume":"63","author":"Cieri","year":"2021","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_19","first-page":"5","article-title":"Mid-arm circumference effectiveness for the nutritional screening of children in primary care","volume":"24","year":"2011","journal-title":"An. Venez. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Dipasquale, V., Aumar, M., Ley, D., Antoine, M., Romano, C., and Gottrand, F. (2022). Tube feeding in neurologically disabled children: Hot topics and new directions. Nutrients, 14.","DOI":"10.3390\/nu14183831"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s13052-020-0800-1","article-title":"Top-ten tips for managing nutritional issues and gastrointestinal symptoms in children with neurological impairment","volume":"46","author":"Dipasquale","year":"2020","journal-title":"Ital. J. Pediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1080\/03007995.2022.2052514","article-title":"Real food in enteral nutrition for chronically ill children: Overview and practical clinical cases","volume":"38","author":"Dipasquale","year":"2022","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Jeli\u010di\u0107 Kadi\u0107, A., Rado\u0161evi\u0107, T., \u017ditko, V., Despot, R., Pogoreli\u0107, Z., Llorente Mu\u00f1oz, C.M., Runji\u0107, E., Kova\u010devi\u0107, T., \u0106atipovi\u0107 Ardali\u0107, T., and Poli\u0107, B. (2021). Percutaneous endoscopic gastrostomy tubes can be considered safe in children: A single-center 11-year retrospective analysis. Medicina, 57.","DOI":"10.3390\/medicina57111236"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/MPG.0000000000002981","article-title":"Antibiotic prophylaxis for percutaneous endoscopic gastrostomy in children: A randomised controlled trial","volume":"72","author":"Alessandri","year":"2021","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1097\/MPG.0000000000003207","article-title":"Percutaneous endoscopic gastrostomy in children: An update to the ESPGHAN position paper","volume":"73","author":"Homan","year":"2021","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"bmjopen-2012-001793","DOI":"10.1136\/bmjopen-2012-001793","article-title":"Timing of gastrostomy insertion in children with a neurodisability: A cross-sectional study of early versus late intervention","volume":"2","author":"Sharma","year":"2012","journal-title":"BMJ Open"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/13\/2875\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:00:24Z","timestamp":1760126424000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/13\/2875"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,25]]},"references-count":26,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["nu15132875"],"URL":"https:\/\/doi.org\/10.3390\/nu15132875","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,25]]}}}