Enteral Nutrition in Pediatric Short-Bowel Syndrome

Nutr Clin Pract. 2020 Oct;35(5):848-854. doi: 10.1002/ncp.10565. Epub 2020 Aug 19.


Pediatric intestinal failure (IF) is the critical reduction of intestinal mass or function below the amount necessary for normal growth in children. Short-bowel syndrome (SBS) is the most common cause of IF in infants and children and is caused by intestinal resection. Enteral autonomy and freedom from parenteral nutrition is the mainstay of nutrition management in SBS. The goal is to achieve intestinal adaptation while maintaining proper growth and development. Treatment is variable, and there remains a paucity of evidence to draw well-informed conclusions for the care of individuals in this complex population. Physiological principles of enteral nutrition and practical recommendations for advancing the diet of patients with pediatric SBS are presented. Emerging trends in nutrition management, such as the growing interest in blending diets and the impact on SBS, are reviewed. Finally, the influence of the microbiome on enteral tolerance and small bowel bacterial overgrowth are considered.

Keywords: bacterial overgrowth; enteral nutrition; microbiome; nutrition support; parenteral nutrition; pediatrics; short-bowel syndrome.

Publication types

  • Review

MeSH terms

  • Adaptation, Physiological
  • Child
  • Diet / methods
  • Enteral Nutrition / methods*
  • Enteral Nutrition / trends
  • Gastrointestinal Microbiome
  • Humans
  • Infant
  • Intestine, Small / physiopathology
  • Intestines / physiopathology
  • Parenteral Nutrition / methods
  • Short Bowel Syndrome / therapy*