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Long-term feeding

Risk of perforation Must be constant infusion of feed Bacterial overgrowth Dumping syndrome can occur

Adapted from MacDonald A, Holden C, and Johnston T (2001) Paediatric enteral nutrition. In Payne-James J, Grimble G, and Silk D (eds.) Artificial Nutrition Support in Clinical Practice, pp. 347-366. London: Greenwich Medical Media.

Adapted from MacDonald A, Holden C, and Johnston T (2001) Paediatric enteral nutrition. In Payne-James J, Grimble G, and Silk D (eds.) Artificial Nutrition Support in Clinical Practice, pp. 347-366. London: Greenwich Medical Media.

Decreased bone mineral density and osteopenia associated with low 25-hydroxyvitamin D levels have been described in patients with CF but may be related to poor nutritional status and delayed puberty. Rickets is rarely seen. Possible contributory factors include low body mass index, disease severity, inadequate calcium intake, delayed puberty, or widespread use of systemic or inhaled steroids.

Blood levels of vitamin E are nearly always low unless supplements are given. In older patients, undetectable serum concentrations of vitamin E have been noted in association with neurological syndromes. Symptoms and signs include absent deep tendon reflexes, loss of position sense and vibration sense in lower limbs, dysarthria, tremor, ataxia, and decreased visual activity.

Some CF centres recommend routine salt supplements to all CF infants on normal infant formula, which is low in sodium, and CF patients during hot weather. Anorexia and poor growth may result from chronic salt depletion. Significant hyponatremia may be accompanied by vomiting.

Food Allergies

Food Allergies

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