Objectives: Short bowel syndrome (SBS) is a complex and rare condition (incidence
1200/100,000 live births) that requires a multidisciplinary team approach to management.
In January 2019, the first European Reference Network on Rare and Inherited Congenital
Anomalies (ERNICA) Intestinal Failure (IF) workshop was held. Several questions about
the strategies used in managing IF associated with SBS were devised. The aim of our
study was to collect data on the enteral feeding strategies adopted by the ERNICA
centres. Methods: A questionnaire (36 questions) about strategies used to introduce
enteral nutrition post-operatively and start complementary food/solids in infants
with SBS associated IF was developed and sent to 24 centres in 15 countries that participated
in the ERNICA-IF workshop. The answers were collated and compared with the literature.
Results: There was a 100% response rate. In infants, enteral nutrition was introduced
as soon as possible, ideally within 24-48 hours post-small intestinal surgical resection.
In 10 of 24 centres, bolus feeding was used, in nine continuous, and in five a combination
of both. Twenty-three centres used mothers' own milk as the first choice of feed with
extensively hydrolysed feed, amino acid-based feed, donor human milk or standard preterm/term
formula as the second choice. Although 22 centres introduced complementary/solid food
by 6 months of age, food choice varied greatly between centres and appeared to be
culturally based. Conclusions: There is diversity in post-surgical enteral feeding
strategies among centres in Europe. Further multi-centre studies could help to increase
evidence-based medicine and management on this topic.
