Pediatric Elemental Diet
Indications And Clinical Uses: Use in the dietary management of children with clinical conditions of short bowel syndrome, inflammatory bowel disease, malabsorption syndrome, cow’s milk protein enteropathy/sensitivity, select multiple trauma/major surgery, Crohn’s disease, gastrointestinal fistula, select pre/post surgery, intractable diarrhea and gastrointestinal disorder related to HIV/AIDS.
Precautions: Do not administer parenterally. For use only under medical supervision. Nausea, vomiting, abdominal cramps, distention and diarrhea are possible. Nausea and diarrhea are usually due to feeding rate or diet concentrations. Local water conditions may be implicated in instances of diarrhea. Preparing diet with deionized or distilled water may be effective in this circumstance.
Aspiration is an uncommon complication. However, radiologically confirm the anatomic position of the feeding tube, elevate head of the bed 30° while the patient is receiving diet intragastrically, and control the administration to 150 mL/hour or less, depending upon patient tolerance. Jejunal administration should also be considered. Diabetics and patients with renal insufficiency receiving this diet should be closely monitored.
Dosage And Administration: 1 250 mL or 4 180 kJ (five 250 mL servings or 1 000 kcal) provides at least 100% of the 1990 Canadian RNI for protein and essential vitamins and minerals for children 1 to 9 years. May be administered by nasogastric, nasointestinal, esophagostomy, gastrostomy or jejunostomy feeding tube. Feed at room temperature. Follow a physician’s or dietitian’s direction. When initiating feeding, the flow rate, volume and dilution are dependent on the patient’s condition and tolerance.
Feeding should be initiated at a slow rate. Rate and volume of feeding can be increased gradually over 48 hours if well tolerated. If intolerance develops, return to previously tolerated rate, or dilute formula to half strength until desired rate is achieved, then switch to full strength. Do not alter strength and volume at the same time. Rinse the tube with 20 to 30 mL water after each intermittent feeding or every 3 to 4 hours during continuous feeding to avoid clogging and provide additional water.
Vivonex Pediatric is a perishable liquid food when diluted in water. A full day’s supply may be prepared at one time and stored in the refrigerator for up to 48 hours, shake the liquid before serving. Do not leave at room temperature for more than 8 hours.
Availability And Storage: Each 48.7 g pouch contains: ¹-D maltodextrin, modified cornstarch, modified coconut oil (medium chain triglycerides), soybean oil, calcium glycerophosphate, L-glutamine, magnesium gluconate, L-lysine acetate, L-leucine, L-arginine acetate, potassium chloride, L-valine, citric acid, L-isoleucine, L-aspartic acid, L-alanine, L-phenylalanine, L-serine, L-proline, L-threonine, L-tyrosine, L-glutamic acid, glycine, L-histidine monohydrochloride monohydrate, L-methionine, potassium citrate, L-cystine, choline bitartrate, polyglycerol esters of fatty acids, sodium citrate, sodium phosphate dibasic, L-tryptophan, potassium sorbate, ascorbic acid, taurine, zinc sulfate, ferrous sulfate, niacinamide, L-carnitine, alpha tocopheryl acetate, copper gluconate, d-calcium pantothenate, manganese sulfate, pyridoxine hydrochloride, riboflavin, thiamine HCl, BHA/BHT (to preserve freshness), vitamin A palmitate, beta carotene, folic acid, chromic acetate, sodium molybdate, potassium iodide, biotin, sodium selenite, vitamin K1, vitamin D3, cyanocobalamin.
The standard dilution of 3.3 kJ (0.8 kcal)/mL has a pH of approximately 5.0 and an average osmolality of 360 mOsm/kg water. Pouches of 48.7 g, cartons of 6, cases of 6 cartons. Store unopened powder below 30°C.
VIVONEX® PEDIATRIC Novartis Nutrition Pediatric Elemental Diet