FEEDING DYSFUNCTION IN INFANTS WITH SEVERE CHRONIC-RENAL-FAILURE AFTER LONG-TERM NASOGASTRIC TUBEFEEDING

Nasogastric tube feeding (NGTF) is frequently necessary to overcome th e inadequate caloric intake of children with severe chronic renal fail ure (CRF). In a multicenter retrospective study, we evaluated feeding dysfunction after tube feeding withdrawal in children with severe CRF who started long-term enteral nutrition early in childhood. We conside red, almost exclusively, infants who had started NGTF very early and c ontinued to be tube fed for at least 9 months. Twelve patients were in cluded in the study: 8 showed significant and persistent eating diffic ulties, with difficulties in chewing and swallowing in 7 and food refu sal in 6. For 2 patients ''panic attacks'' from swallowing were repeat edly reported. These problems persisted for more than year in 5 patien ts and between 1 and 6 months in 4. The possible feeding difficulties that may follow NTGF must be carefully evaluated. A possible means of overcoming these difficulties might include: encouraging the use of a pacifier, proposing water for spontaneous assumption, leaving the chil d the possibility of eating food spontaneously during the daytime, and increased support for the parents during weaning. These need prospect ive study.