Dr. Norma from from NPH Honduras was recently invited to go to Italy for intensive training on nutrition and feeding for children with cerebral paralysis and other severe conditions. This was a great accomplishment since patients who cannot maintain an adequate caloric intake waste a lot of weight and muscle and are prompt to have lung infections, such as pneumonia secondary to food aspiration.

Children living in the NPH Honduras Casa Angeles home, are severely handicapped with medical conditions from severe grade of cerebral paralysis from birth to a variety of syndromes with swallowing difficulties.

When a patient cannot maintain an adequate caloric intake with a regular diet, there are supplemental products that can help to provide adequate nutrition and/or facilitate the patient process to slow the food. There are also additional feeding methods to reduce the risk of aspiration, though always we want to exhaust the resource of giving natural food by mouth.

Alternative feeding methods are offered when the child

• Has the swallowing function diminished
• Loss weight quickly
• Shows signs of dehydration

There are two ways to provide enteral nutrition.

1-Nasogastric tube or NG, which is a special tube that carries the food and medicines to the stomach through the nose. To use this method the caregivers need to be very well trained in order to properly care for the feeding, flushing the tube to release any formula, knowing the formula and quantity as well, and how to care for the skin around the tube.

2- Percutaneous endoscopic gastrostomy tube (PEG). With correct training and adequate food the enteral nutrition is helping some of the children with difficulty to swollen by gaining weight and muscle and being more awake and interactive.

We would like to thanks NPH Italy and Dr. Arrigo Barabino and his staff for their support and training in this initiative for the wellbeing of our children.