Maintaining adequate nutrition is an important part of care for acutely and chronically ill patients.1  Patients who are malnourished have more infections and complications, use more resources, and have poorer clinical outcomes than patients who are well nourished.2–4  Maintenance of adequate nutrition is particularly important in children.5  Children have lower energy reserves, lower percentage of muscle mass and fat, and proportionately higher nutrient and energy needs when compared with adults.1,5,6  Malnutrition in pediatric intensive care units is reported to vary between 25% and 70%.6 

Feeding patients via an enteral tube is a frequent part of care for children who are acutely ill.7  Directly feeding the small bowel via a postpyloric or transpyloric feeding tube is indicated when the gastrointestinal tract is functional, however there are several conditions that cause gastric feeding to fail such as an absent gag...

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