The risk of malnutrition3-5
Inadequate oral intake due to
- Critical illnesses
- Digestion
- Absorption disorders
Increased nutritional requirements caused by
- Acute metabolic stress or
- Chronic diseases
may lead to malnutrition in children.
Disease-related malnutrition - a problem to be solved
Malnutrition in children is common and remains being underestimated.1 Prevalence of malnutrition is 2-fold higher in hospitalized patients than in patients assessed at the out-patient and day-hospital clinics.2 Frebini® Drinks and Tube Feeds are based on state of the art scientific evidence, and formulated with over 30 years of expertise in Enteral Nutrition to meet the higher nutritional needs of children who are at risk of or have disease-related malnutrition.
Malnutrition negatively impacts growth and causes development impairment and is associated with far reaching consequences:6
- Adverse effects on learning, behaviour and cognition6
- Poor performance in tests of cognitive flexibility, attention, working memory, visual perception, verbal comprehension and memory7
- Early growth faltering was associated with a significantly lower total intelligence quotient8
1 in 2 children admitted to hospitals has malnutrition.2
Children with underlying diseases represent a more nutritionally vulnerable community.3
Frebini® Drinks and Tube Feeds have been providing your patients with moments of Relief for over 30 years
Watch the video to find out more.
Malnutrition in children is associated with:
- Impaired growth and development6,7
- Increased length of hospital stay9,10
- Increased morbidity11
- Increased mortality11
- Higher health care costs9,12
Comorbidities of malnutrition in children admitted to hospital12
17% Infectious
25% Cardiac
14% Surgical
13% Oncology
28% Gastrointestinal
31% Neurological
30% Respiratory
15% Others
The nutritional requirements in sick children are significantly increased compared to healthy children.
Higher protein needs to catch up growth and/or disease specific higher demands due to:13-18
- Infection
- Wound healing
- Maintenance of weight
- Impaired GI function
- Diarrhoeal losses
Frebini® Drinks and Tube Feeds are formulated to avoid or reverse the negative effects of malnutrition for chronically or acutely ill children to help them catch up with growth and to meet their disease-specific demands.
Guideline-aligned Frebini® formulas contain high-quality protein to meet the increased protein requirements for effective nutritional management of paediatric patients.
Find out more about the scientific background of Frebini products by downloading this folder.
Frebini Portfolio Folder.pdf
Find out more about the scientific background of Frebini products by downloading this folder.
- Filename
- Frebini Portfolio Folder.pdf
- Size
- 4 MB
- Format
Effective nutritional management of your younger patients leads to improved outcomes on their overall well-being19-21
Diagnosis of malnutrition is the key9
For effective nutritional management all children need to be screened for risk of malnutrition
References:
1. ONS to tackle malnutrition. A summary of evidence base. Medical Nutrition International Industry (MNI), 2012.
2. Diamanti A, Cereda E, Capriati T, Giorgio D, Brusco C, Liguori A, et al. Prevalence and outcome of malnutrition in pediatric patients with chronic diseases:
Focus on the settings of care. Clin Nutr. 2019;38(4):1877-82
3. Braegger C, Decsi T, Dias JA, Hartman C, Kolacek S, Koletzko B, Koletzko S, Mihatsch W, Moreno L, Puntis J, Shamir R, Szajewska H, Turck D, van Goudoever J;
ESPGHAN Committee on Nutrition: Practical approach to paediatric enteral nutrition: a comment by the ESPGHAN committee on nutrition. J Pediatr
Gastroenterol Nutr. 2010 Jul;51(1):110-22. doi: 10.1097/MPG.0b013e3181d336d2. PMID: 20453670.
4. Axelrod D, Kazmerski K, Iyer K. Pediatric enteral nutrition. JPEN J Parenter Enteral Nutr. 2006 Jan-Feb;30(1 Suppl):S21-6. doi: 10.1177/01486071060300S1S21.
PMID: 16387906.
5. Gibbons T, Fuchs GJ. Malnutrition: a hidden problem in hospitalized children. Clin Pediatr (Phila). 2009 May;48(4):356-61. doi: 10.1177/0009922808324493.
Epub 2008 Oct 2. PMID: 18832529.
6. Corbett SS, Drewett RF. To what extent is failure to thrive in infancy associated with poorer cognitive development? A review and meta-analysis. J Child
Psychol Psychiatry. 2004 Mar;45(3):641-54. doi: 10.1111/j.1469-7610.2004.00253.x. PMID: 15055382.
7. Black MM, Dubowitz H, Krishnakumar A, Starr RH Jr. Early intervention and recovery among children with failure to thrive: follow-up at age 8. Pediatrics.
2007 Jul;120(1):59-69. doi: 10.1542/peds.2006-1657. PMID: 17606562.
8. Sobotka, Luboš and Alastair Forbes. Basics in clinical nutrition. edition 5, Galen, 2019.
9. Hulst JM, Zwart H, Hop WC, Joosten KF. Dutch national survey to test the STRONGkids nutritional risk screening tool in hospitalized children. Clin Nutr. 2010
Feb;29(1):106-11. doi: 10.1016/j.clnu.2009.07.006. Epub 2009 Aug 13. PMID: 19682776.
10. Agostoni C, Axelson I, Colomb V, Goulet O, Koletzko B, Michaelsen KF, Puntis JW, Rigo J, Shamir R, Szajewska H, Turck D; ESPGHAN Committee on Nutrition; European Society for Paediatric Gastroenterology. The need for nutrition support teams in pediatric units: a commentary by the ESPGHAN committee on
nutrition. J Pediatr Gastroenterol Nutr. 2005 Jul;41(1):8-11. doi: 10.1097/01.mpg.0000163735.92142.87. Erratum in: J Pediatr Gastroenterol Nutr. 2005
Aug;41(2):267-71. PMID: 15990621.
11. Mehta NM, Corkins MR, Lyman B, Malone A, Goday PS, Carney LN, Monczka JL, Plogsted SW, Schwenk WF; American Society for Parenteral and Enteral
Nutrition Board of Directors. Defining pediatric malnutrition: a paradigm shift toward etiology-related definitions. JPEN J Parenter Enteral Nutr. 2013
Jul;37(4):460-81. doi: 10.1177/0148607113479972. Epub 2013 Mar 25. PMID: 23528324.
12. Joosten KF, Zwart H, Hop WC, Hulst JM. National malnutrition screening days in hospitalised children in The Netherlands. Arch Dis Child. 2010
Feb;95(2):141-5. doi: 10.1136/adc.2008.157255. Epub 2009 May 3. PMID: 19414435.
13. Mehta NM et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care
Medicine and American Society for Parenteral and Enteral Nutrition. J Parenteral and Enteral Nutrition 2017; 41(5):706-742.
14. Bechard LJ, Parrott JS, Mehta NM. Systematic Review of the Influence of Energy and Protein Intake on Protein Balance in Critically Ill Children. The Journal
of Pediatrics. 2012;161(2):333-9.e1.
15. Jaksic T. Effective and efficient nutritional support for the injured child. Surg Clin North Am 2002; 82(2): 379-391.
16. Robin C. Cook, Thane A. Blinman, Nutritional support of the pediatric trauma patient, Seminars in Pediatric Surgery,2010; 19(4): 242-251
17. Corkins MR et Balint J. Pediatric nutrition support handbook. Silver Spring (MD): American Society for Parenteral and Enteral Nutrition, 2011.
18. Turck D, et al ESPENESPGHAN-ECFS guidelines on nutrition care for infants, children, and adults with cystic fibrosis. Clinl Nutr 2016; 35(3): 557-577.
19. Wang X, Pan L, Zhang P, et al. Enteral nutrition improves clinical outcome and shortens hospital stay after cancer surgery. Journal of Investigative Surgery.
2010;23(6):309-13.
20. Joosten KF, Hulst JM. Malnutrition in pediatric hospital patients: current issues. Nutrition 2011; 27(2):133-137.
21. Mehta NM, Skillman HE, Irving SY, Coss-Bu JA, Vermilyea S, Farrington EA, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Pediatr Crit Care Med.
2017;18(7):675-715.