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# Enteral Feedings Caloric and nutritional needs for enteral feedings are assessed according to the age of the child, size, and stress factors. Breast milk is the optimal nutrition for infants. Feedings may be adjusted because of needs associated with diseases; for example, children with heart fail...

# Enteral Feedings Caloric and nutritional needs for enteral feedings are assessed according to the age of the child, size, and stress factors. Breast milk is the optimal nutrition for infants. Feedings may be adjusted because of needs associated with diseases; for example, children with heart failure may require fluid restriction. Formula usually contains 24/30 calories per ounce. Caloric requirements are based on the RDA and resting energy expenditure (REE), the calories needed for a child at rest: * **6 months to 1 year:** * RDA: Kcal/kg/d - 90 to 108 * REE: Kcal/kg/d - 55 * Protein: g/kg/d - 2 to 2.5 * **1 to 3 years:** * RDA: Kcal/kg/d - 85 to 102 * REE: Kcal/kg/d - 50 to 57 * Protein: g/kg/d - 1.2 to 3 * **4 to 6 years:** * RDA: Kcal/kg/d - 70 to 90 * REE: Kcal/kg/d - 45 to 48 * Protein: g/kg/d - 1.1 to 3 * **7 to 10 years:** * RDA: Kcal/kg/d - 60 to 70 * REE: Kcal/kg/d - 40 * Protein: g/kg/d - 1.0 to 3 * **11 to 13 years:** * RDA: Kcal/kg/d - 45 to 55 * REE: Kcal/kg/d - 28 to 32 * Protein: g/kg/d - 1.0 to 2.5 * **15 to 18 years:** * RDA: Kcal/kg/d - 36 to 45 * REE: Kcal/kg/d - 25 to 27 * Protein: g/kg/d - 0.8 to 1.2 ## TEE - Total Energy expenditure (TEE) is calculated by multiplying the resting energy expenditure (REE) by stress factors: * **Maintenance:** 0.2 * **Activity:** 0.1 to 0.25 * **Fever:** 0.13 per degree>38°C * **Burns:** 0.5 to 1 * **Simple trauma:** 0.2 * **Sepsis/major trauma:** 0.4 to 1.5 * **Ventilation/sedation:** 1.2 to 1.3 * **Growth:** 0.5 ## Preventing Occlusion and Flushing of Enteral Feeding Tubes Prevention of occlusion of enteral feeding tubes involves proper administration of medications and feedings, and maintaining a regular schedule of flushing. Tubes should be flushed with 5 to 30 ml of