Nutritional support at home and in the community

Technical developments in feeding, together with the growth of support stru ctures in the community has lead to a steady increase in the number of chil dren receiving home enteral tube feeding and home parenteral nutrition. In many cases the adverse nutritional consequences of disease can be ameliorat ed or prevented, and long term parenteral nutrition represents a life savin g intervention. Careful follow up of children receiving home nutritional th erapy is necessary to establish the ratio of risks to benefits. A considera ble burden is sometimes placed on family or other carers who therefore requ ire adequate training and ongoing support. The respective responsibilities of different agencies relating to funding and support tasks require more cl ear definition.