Background The prevalence of children with neuro-disability has become more common due to advances in the medical management of preterm infants. Although tube feeding improves overall nutritional status, it has also been associated with excess body fat. Commercially available enteral formulas that are low in energy but nutritionally adequate for protein and micronutrients are available to help reduce obesity in children with neuro-disabilities.

Methods Retrospective multicentre review of children who attended neuro-disability clinics between January 2022 to July 2023. We collected demographic, anthropometric and feeding history. Data was collected before the formula was changed and one month after receiving the low-energy partially hydrolysed enteral formula Peptamen Junior 0.6kcal/ml

Results Dietitians collected data on 28 children. The most frequently recorded neuro-disability was cerebral palsy, 13 of 28 children (48%). Before the formula switch, all 28 children were experiencing excessive weight gain on their current feeding regimen. After the formula was switched to low-energy hydrolysed formula dietitians reported that 20 of the 28 (76%) children’s weight either stabilised or reduced after one month. Prior to the formula switch, the most frequently reported feed intolerance symptom was constipation, in 13 of 28 children. Within one month of switching to a low-energy hydrolysed formula 10 of the 13 (77%) children reported an improvement in constipation. The number of children whose feeding regimens were simplified after switching to a ‘ready to feed’, low-energy partially hydrolysed formula was 24 of 28 (91%).

Conclusions Children with neuro-disability who have feeding intolerances may benefit from a low-energy hydrolysed enteral formula to maximise tolerance and minimise excess weight gain. This formula transition may also simplify feeding regimens by eliminating the need for additional electrolytes, multivitamins, and fluid boluses. Healthcare professionals should be knowledgeable of the effectiveness and availability of low-energy, nutritionally complete formulas for tube-fed children with neuro-disabilities.