Paediatric Intensive Care Nutrition

About this PSP

The Paediatric Intensive Care Nutrition JLA PSP worked with patients, carers and clinicians to identify uncertainties related to nutrition in infants and children on an intensive care setting within all stages of the patient pathway, including immediate and post intensive care.

The PSP was funded by The Association of UK Dietitians.

The Paediatric Intensive Care Nutrition PSP Top 10 was published in May 2022.


PSP website


Articles and publications

Key documents

Paediatric Intensive Care Nutrition PSP Protocol

Paediatric Intensive Care Nutrition PSP Steering Group Terms of Reference

Paediatric Intensive Care Nutrition PSP Question Verification Form

Paediatric Intensive Care Nutrition Engagement Summary

Final-version-PICU-Nutrition-JLA-PSP-data-management-spreadsheet.xlsx

Paediatric-Intensive-Care-Nutrition-PSP-Interim-Prioritisation-survey-poster.pdf

Top 10 priorities

  1. Can energy needs of babies on breathing machines be more accurately measured using indirect calorimetry?
  2. What are the long term feeding problems in relation to Post Intensive Care Syndrome once a child is discharged home from intensive care?
  3. Does a high protein feed formula combined with early mobilisation reduce muscle wasting in children on breathing machines?
  4. Can parents’ nutritional beliefs and preferences be better understood by healthcare professional and included into the care of their child on breathing machines?
  5. When should intravenous nutrition start in very underweight critically ill children who DO NOT have a working digestive system?
  6. What is the definition of feed intolerance in children on breathing machines?
  7. Does giving probiotics (healthy bacteria) reduce the risk of hospital acquired infections in children on breathing machines?
  8. Does a child’s swallowing change as a result of having needed a breathing tube?
  9. What strategies should be in place on PICU to help with parental bonding with their baby when breast feeding is not possible?
  10. Do the energy (calorie) needs change for children who have been on a breathing machine for more than 5 days with no change in activity level?

The following questions were also discussed and put in order of priority at the workshop:

  1. Is feeding into the small bowel (postpyloric/jejunal) better tolerated than feeding into stomach in children who are receiving noninvasive ventilation (such as face mask—continuous positive airway pressure/BiPAP)?
  2. What is the impact of postintensive care syndrome on growth?
  3. Is bolus feeding better than slow continuous pump feeding in children on breathing machines?
  4. Can nonnutritive feeding (use of dummies/pacifier) reduce feeding aversion for infants on breathing machines?
  5. Can a low carbohydrate diet reduce illness related stress (sepsis) to infection (such as hyperlactatemia and hyperglycemia) in children on breathing machines?
  6. Can specific types of proteins (branch chain amino acids) reduce muscle loss in children who are on breathing machines for more than 7 days?
  7. Does giving probiotics in children on breathing machines reduce inflammation (cytokines)?
  8. Is there a safe dose of probiotics (healthy bacteria) for children with low immune function (immunosuppression or immunocompromised) on breathing machines?