ABSTRACT
Nutrition in children with palliative care needs impacts their quality of life, clinical progress and prognosis. Factors that impact nutrition include the child's ability to feed, gut motility, ability to absorb nutrients, other contributory physiological and psychosocial factors. In addition, as children grow, their nutritional intake must meet their developmental needs. Optimising the child's health and QOL must include delivering the appropriate nutrition, via the appropriate feeding route, with an appropriate regimen, as well as managing the underlying contributors to the child's nutritional difficulties. This chapter considers the multiple factors that affect nutrition, their possible management strategies and the specific nutritional issues in the context of end-of-life care. It discusses the different methods of feeding commonly encountered, as well as guidance for managing the symptoms that may compromise nutrition in a child with life-limiting/life-threatening conditions. It is important that the burden of various interventions, especially tube feeding, is not under-estimated and be made easier by a co-ordinated approach by the multi-professional team, with an individualised plan considered for each family.
