Name of the Procedure:

Enteral Formula for Pediatrics - Hydrolyzed/Amino Acids and Peptide Chain Proteins

• Common names: Pediatric hydrolyzed enteral formula, amino acid-based formula.
• Technical term: Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins, and minerals, may include fiber, administered through an enteral feeding tube (HCPCS Code: B4161).

Summary

An enteral formula designed specifically for children, composed of hydrolyzed proteins, amino acids, fats, carbohydrates, vitamins, and minerals. This special formula is administered directly through a feeding tube to ensure that children who cannot eat by mouth receive necessary nutrition. Each unit represents 100 calories.

Purpose

• Medical conditions addressed: Gastrointestinal disorders, severe food allergies, malabsorption syndromes, protein intolerance, and other conditions preventing normal digestion or absorption of nutrients.
• Goals: To provide complete and balanced nutrition in an easily digestible form, support growth and development, and prevent malnutrition in pediatric patients unable to consume regular food orally.

Indications

• Symptoms requiring the formula include chronic diarrhea, vomiting, severe allergic reactions, and failure to thrive due to nutrient malabsorption.
• Patient factors: Children with medical conditions that impair their ability to digest and absorb regular food or formula.

Preparation

• Pre-procedure instructions: Ensure feeding tube placement is verified and functioning properly.
• Diagnostic tests: Confirmation of the medical necessity for enteral feeding (e.g., endoscopy, gastroenterology consultation).

Procedure Description

1. Verify and prepare the enteral feeding tube.
2. Check the formula's expiration date and nutritional content.
3. Warm the formula to room temperature, if required.
4. Attach the formula container to the feeding tube using a feeding pump or syringe.
5. Administer the formula at a prescribed rate and volume as per the healthcare provider's instructions.
   • Tools used: Enteral feeding pump or gravity drip system, feeding tube, syringe.
   • Anesthesia/sedation: Not required.

Duration

• The feeding session duration depends on the volume and rate of the formula administration, typically ranging from 20 minutes to several hours.

Setting

• The procedure can be performed both in healthcare settings such as hospitals or outpatient clinics and at home under medical supervision.

Personnel

• Involves healthcare professionals such as pediatricians, gastroenterologists, dietitians, and nursing staff.

Risks and Complications

• Common risks: Tube blockage, irritation at the tube site, gastrointestinal discomfort.
• Rare risks: Aspiration pneumonia, infection at the tube site, metabolic imbalances which may require medical intervention.

Benefits

• Expected benefits: Improved nutrition and growth, better management of underlying conditions, enhanced quality of life.
• Timeframe: Benefits are generally realized quickly, often within days to weeks.

Recovery

• Post-procedure care: Regular monitoring of tube placement and site cleanliness, periodic medical evaluations.
• Recovery time: Ongoing, as enteral feeding is usually long-term until the patient can transition to oral feeding.
• Restrictions: Maintain feeding tube patency, follow dietary guidelines, and attend follow-up appointments.

Alternatives

• Other options: Parenteral nutrition (intravenous feeding), specialized oral diets if feasible.
• Pros and cons:
  • Parenteral nutrition: Provides nutrition intravenously but carries a higher risk of complications and is more complex.
  • Specialized oral diets: Less invasive but not always possible depending on the severity of the patient's condition.

Patient Experience

• During procedure: Generally painless, but the child may experience discomfort due to the feeding tube.
• After procedure: Regular feeding through the tube can be managed comfortably with minor adjustments for optimal tolerance.
• Pain management: Minimal pain related to tube insertion; analgesics rarely required.