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SUN-P232: A Survey Of Complementary Feeding Practices Recommended Among Health Professionals
S130 Conclusion: The influence of certain nutritional factors early in life on later growth patterns could be influenced by appropriate nutritional interventions. Longer breastfeeding protects against rapid weight gain as well as lower protein intake in the first year of life. Disclosure of Interest: None declared
SUN-P231 STANDARDIZATION OF PROCEDURES AND PRACTICES FOR PAEDIATRIC PATIENTS ON HOME PARENTERAL NUTRITION IS EFFECTIVE IN THE PREVENTION OF CATHETER RELATED COMPLICATIONS J. De Cloet1, E. Oudaert1, M. Van Winckel2, J. Vandenbroucke1, S. Commeyne1. 1Pharmacy Department, 2Paediatric Gastroenterology Department, University Hospital Ghent, Ghent, Belgium Rationale: For patients with intestinal failure is home parenteral nutrition (HPN) since decades seen as the best option in reducing high hospital costs and improving quality of life. A standard procedure of care for infants and children discharged on HPN was implemented: a two week intensive teaching program before discharge, the daily catheter care by an experienced home care nurse, use of standardized material and all-in-one (AIO) paediatric admixtures. We aimed to evaluate the effectiveness of this measures in the prevention of catheter complications. Methods: A single centre retrospective cohort study was performed which included all patients <18 years that were discharged on HPN and received standardized AIO admixtures since 2008. Data collected were: age of onset of HPN, duration, frequency and reason for HPN discontinuation, number and type of catheter complications. Results: A total of 18 paediatric patients were included representing 15.823 HPN days. The incidence of catheterrelated bloodstream infections (CRBSI) was 1.16 episodes/ 1,000 HPN days and 0.25 catheter occlusions/1,000 HPN days. Nine patients experienced catheter complications (7 CRBSI, 3 catheter occlusion). The median HPN duration was 350 days [10 days–13.8 years]. Eleven patients could be successfully weaned off PN during the eight-year observation period. Conclusion: The use of stable AIO paediatric admixtures who are less prone to physicochemical incompatibilities such as precipitation or destabilisation and catheter lock by a positive pressure valve in combination with normal saline instead of heparin contributes to a low incidence of catheter occlusions and CRBSI. These findings suggest that the standard procedures and practices for infants and children depending on HPN are effective in the prevention of catheter complications and contribute to a better quality of life. Disclosure of Interest: None declared
SUN-P232 A SURVEY OF COMPLEMENTARY FEEDING PRACTICES RECOMMENDED AMONG HEALTH PROFESSIONALS L. Ladino1, R. Vázquez2, C. Bagés1, O. J. Quintero3, N. Ramos4. 1 IINGM Institute of Research in Nutrition, Genetics and Metabolism, El Bosque University, Bogotá D.C, Colombia; 2 Gastroenterology and Nutrition, Hospital Infantil de México, México D.F., Mexico; 3Gastroenterology, Hepatology and Nutrition, Fundación Cardioinfantil, 4Paediatrics, Medicine School, El Bosque University, Bogotá D.C, Colombia
Poster Rationale: Continued Medical Education (CME) in paediatric nutrition is common. The aim was to assess the complementary feeding practices recommended among health professionals. Methods: NuPed is a CME online course in paediatric nutrition for health proffesionals, leaded by Colombian Society of Paediatrics. A survey was sent to participants of NuPed to assess complementary feeding (CF) practices recommended. Descriptive statistics was applied in SPSS 21.0. Results: A total of 167/218 responses were received, for an overall response rate of 76.6%. The participants were from 6 countries, mainly Colombia. Participants mainly are physicians 62%, nutritionists 36% and nurses 2%. The majority are paediatricians 59% although 41% does not have any postgraduate study. According to CF practices recommended by health proffesionals, 85.6% recommends introduce CF between 4–6 mo, 61.6% thinks to introduction of CF should be equal between breastfed and formula-fed infants. Health proffesionals recommend to introduce allergenic foods mainly as following: egg 7–9 mo, wheat 7–9 mo, fish >12 mo, strawberries >12 mo, peanut >12 mo, soy >12 mo, cow milk >12 mo. More than 50% recommends introduce yogurt and cheese after 12 mo. More than 60% does not recommends juices and more than 90% neither recommends sugar and salt into CF. 76.6% recommends to use oils into CF. The majority does not recommend to use of vitamin D supplement in breastfed infants. More than 70% recommends to use infant cereals in CF. 88.6% and 95.8% considers that vegetarian and vegan diet respectively, does not appropiate for growth and development of infants. Conclusion: The health professionals recommend wrong complementary feeding practices on the introduction of allergenic foods and supplementation in breastfed infants. The gaps in the knowledge of the complementary feeding recommendations are an opportunity for additional CME. Reference http://www.scpaulavirtual.com Disclosure of Interest: None declared
SUN-P233 SAFETY ALERT OF MANGANESE OVERDOSE IN INFANTS M. Pietka1, S. Klek2, D. Stę pska-Bodzoń3, A. Przybyło3, A. Kowalik3, W. Brniak1. 1Pharmacy Unit, 2General Surgery Unit, Stanley Dudrick’s Memorial Hospital, 3Pharmacy Unit, Stanley Dudrick’s Memorial Hospital, Skawina, Poland Rationale: Manganese (Mn) is an essential trace element (TE) for normal growth and development. Infants receive Mn from infant formulae or breast milk. Significant differences of Mn content between formula exist. Excessive Mn exposure is neurotoxic, but adaptative mechanisms in the gut avoid it. Infants who required parenteral nutrition (PN) to complement any enteral intake is often supplemented with TE, which also contain Mn. It is reason to be worried about excessive Mn exposure in this infants, because parenteral Mn has nearly 100% bioavailability and intravenous nutrition bypasses regulatory intestinal mechanisms. Methods: Data on demography, dose and kind of milk and PN formula from 1 month from neonatology unit located in Poland were analyzed. Total amount of Mn was calculated. The intestinal absorption was considered as 8% for breast milk and 3% for infant formulae.
SUN-P231 STANDARDIZATION OF PROCEDURES AND PRACTICES FOR PAEDIATRIC PATIENTS ON HOME PARENTERAL NUTRITION IS EFFECTIVE IN THE PREVENTION OF CATHETER RELATED COMPLICATIONS J. De Cloet1, E. Oudaert1, M. Van Winckel2, J. Vandenbroucke1, S. Commeyne1. 1Pharmacy Department, 2Paediatric Gastroenterology Department, University Hospital Ghent, Ghent, Belgium Rationale: For patients with intestinal failure is home parenteral nutrition (HPN) since decades seen as the best option in reducing high hospital costs and improving quality of life. A standard procedure of care for infants and children discharged on HPN was implemented: a two week intensive teaching program before discharge, the daily catheter care by an experienced home care nurse, use of standardized material and all-in-one (AIO) paediatric admixtures. We aimed to evaluate the effectiveness of this measures in the prevention of catheter complications. Methods: A single centre retrospective cohort study was performed which included all patients <18 years that were discharged on HPN and received standardized AIO admixtures since 2008. Data collected were: age of onset of HPN, duration, frequency and reason for HPN discontinuation, number and type of catheter complications. Results: A total of 18 paediatric patients were included representing 15.823 HPN days. The incidence of catheterrelated bloodstream infections (CRBSI) was 1.16 episodes/ 1,000 HPN days and 0.25 catheter occlusions/1,000 HPN days. Nine patients experienced catheter complications (7 CRBSI, 3 catheter occlusion). The median HPN duration was 350 days [10 days–13.8 years]. Eleven patients could be successfully weaned off PN during the eight-year observation period. Conclusion: The use of stable AIO paediatric admixtures who are less prone to physicochemical incompatibilities such as precipitation or destabilisation and catheter lock by a positive pressure valve in combination with normal saline instead of heparin contributes to a low incidence of catheter occlusions and CRBSI. These findings suggest that the standard procedures and practices for infants and children depending on HPN are effective in the prevention of catheter complications and contribute to a better quality of life. Disclosure of Interest: None declared
SUN-P232 A SURVEY OF COMPLEMENTARY FEEDING PRACTICES RECOMMENDED AMONG HEALTH PROFESSIONALS L. Ladino1, R. Vázquez2, C. Bagés1, O. J. Quintero3, N. Ramos4. 1 IINGM Institute of Research in Nutrition, Genetics and Metabolism, El Bosque University, Bogotá D.C, Colombia; 2 Gastroenterology and Nutrition, Hospital Infantil de México, México D.F., Mexico; 3Gastroenterology, Hepatology and Nutrition, Fundación Cardioinfantil, 4Paediatrics, Medicine School, El Bosque University, Bogotá D.C, Colombia
Poster Rationale: Continued Medical Education (CME) in paediatric nutrition is common. The aim was to assess the complementary feeding practices recommended among health professionals. Methods: NuPed is a CME online course in paediatric nutrition for health proffesionals, leaded by Colombian Society of Paediatrics. A survey was sent to participants of NuPed to assess complementary feeding (CF) practices recommended. Descriptive statistics was applied in SPSS 21.0. Results: A total of 167/218 responses were received, for an overall response rate of 76.6%. The participants were from 6 countries, mainly Colombia. Participants mainly are physicians 62%, nutritionists 36% and nurses 2%. The majority are paediatricians 59% although 41% does not have any postgraduate study. According to CF practices recommended by health proffesionals, 85.6% recommends introduce CF between 4–6 mo, 61.6% thinks to introduction of CF should be equal between breastfed and formula-fed infants. Health proffesionals recommend to introduce allergenic foods mainly as following: egg 7–9 mo, wheat 7–9 mo, fish >12 mo, strawberries >12 mo, peanut >12 mo, soy >12 mo, cow milk >12 mo. More than 50% recommends introduce yogurt and cheese after 12 mo. More than 60% does not recommends juices and more than 90% neither recommends sugar and salt into CF. 76.6% recommends to use oils into CF. The majority does not recommend to use of vitamin D supplement in breastfed infants. More than 70% recommends to use infant cereals in CF. 88.6% and 95.8% considers that vegetarian and vegan diet respectively, does not appropiate for growth and development of infants. Conclusion: The health professionals recommend wrong complementary feeding practices on the introduction of allergenic foods and supplementation in breastfed infants. The gaps in the knowledge of the complementary feeding recommendations are an opportunity for additional CME. Reference http://www.scpaulavirtual.com Disclosure of Interest: None declared
SUN-P233 SAFETY ALERT OF MANGANESE OVERDOSE IN INFANTS M. Pietka1, S. Klek2, D. Stę pska-Bodzoń3, A. Przybyło3, A. Kowalik3, W. Brniak1. 1Pharmacy Unit, 2General Surgery Unit, Stanley Dudrick’s Memorial Hospital, 3Pharmacy Unit, Stanley Dudrick’s Memorial Hospital, Skawina, Poland Rationale: Manganese (Mn) is an essential trace element (TE) for normal growth and development. Infants receive Mn from infant formulae or breast milk. Significant differences of Mn content between formula exist. Excessive Mn exposure is neurotoxic, but adaptative mechanisms in the gut avoid it. Infants who required parenteral nutrition (PN) to complement any enteral intake is often supplemented with TE, which also contain Mn. It is reason to be worried about excessive Mn exposure in this infants, because parenteral Mn has nearly 100% bioavailability and intravenous nutrition bypasses regulatory intestinal mechanisms. Methods: Data on demography, dose and kind of milk and PN formula from 1 month from neonatology unit located in Poland were analyzed. Total amount of Mn was calculated. The intestinal absorption was considered as 8% for breast milk and 3% for infant formulae.