Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
American Academy of Pediatrics
Article

Refeeding Syndrome

Christian D. Pulcini, Stacey Zettle and Arvind Srinath
Pediatrics in Review December 2016, 37 (12) 516-523; DOI: https://doi.org/10.1542/pir.2015-0152
Christian D. Pulcini
*Department of Pediatrics,
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Stacey Zettle
†Department of Clinical Nutrition, and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Arvind Srinath
‡Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Comments
  • Quiz
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF
  1. Christian D. Pulcini, MD, MEd, MPH*
  2. Stacey Zettle, MS, RD, LDN†
  3. Arvind Srinath, MD‡
  1. *Department of Pediatrics,
  2. †Department of Clinical Nutrition, and
  3. ‡Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA.
  • AUTHOR DISCLOSURE

    Drs Pulcini and Srinath and Ms Zettle have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Practice Gap

Refeeding syndrome can have potentially devastating metabolic consequences. It is important for the clinician to identify at-risk populations and to evaluate, recognize, and effectively manage this condition.

Objectives

After completing this article, readers should be able to:

  1. Define refeeding syndrome.

  2. Analyze patient scenarios for refeeding syndrome risk factors.

  3. Evaluate the patient at risk for refeeding syndrome.

  4. Interpret refeeding syndrome sequelae.

  5. Manage the patient with refeeding syndrome.

Case Examples

  • Case #1: A 3-month-old infant is directly admitted to the hospital by his pediatrician for failure to thrive.

  • Case #2: A 16-year-old girl with anorexia nervosa fails outpatient treatment and is referred for emergency department evaluation. Five months ago, the patient’s body mass index (BMI) was 18 and Z-score was -1.05, indicating mild malnutrition. Her current BMI is 14 and Z-score is -3.95, indicating severe malnutrition. (1)

  • Case #3: A 9-year-old boy with multiple medical problems who is tracheostomy- and gastrostomy tube-dependent is referred to the hospital because of a 9-lb weight loss in the last 2 months.

Introduction

Refeeding syndrome was first described in the 1940s. (2) However, there is little consensus on the evaluation and management of this condition, particularly in children. One of the primary reasons for this lack of agreement is the inherent difficulty in studying patients with refeeding syndrome. In the 1940s, the Minnesota Starvation Experiment prospectively examined the effects of prolonged starvation in adults via a randomized, controlled trial, but this remains one of the few experiments of its kind examining this condition. (3) The reason for the dearth of research is likely due to the highly morbid complications of refeeding syndrome and …

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Pay Per Article - You may access this article (from the computer you are currently using) for 2 days for US$25.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics in Review: 37 (12)
Pediatrics in Review
Vol. 37, Issue 12
1 Dec 2016
  • Table of Contents
  • Table of Contents (PDF)
  • About the Cover
  • Index by author
  • Complete Issue (PDF)
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Refeeding Syndrome
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Refeeding Syndrome
Christian D. Pulcini, Stacey Zettle, Arvind Srinath
Pediatrics in Review Dec 2016, 37 (12) 516-523; DOI: 10.1542/pir.2015-0152

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Quiz
Share
Refeeding Syndrome
Christian D. Pulcini, Stacey Zettle, Arvind Srinath
Pediatrics in Review Dec 2016, 37 (12) 516-523; DOI: 10.1542/pir.2015-0152
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Practice Gap
    • Objectives
    • Case Examples
    • Introduction
    • Definition
    • Epidemiology
    • Risk Factors
    • Pathogenesis
    • Recognizing the Clinical Manifestations of Refeeding Syndrome
    • Monitoring and Management of Refeeding Syndrome
    • Enteral Versus Parenteral Feeding
    • Cases Revisited
    • References
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Comments
  • Quiz

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • Identification and Management of Eating Disorders in Children and Adolescents
  • Incidence of Refeeding Syndrome in Children With Failure to Thrive
  • Google Scholar

More in this TOC Section

  • Review of Scabies Infestation and Selected Common Cutaneous Infections
  • Pediatric Ingestions: New High-Risk Household Hazards
  • Iron Deficiency: Implications Before Anemia
Show more Article

Similar Articles

Subjects

  • Medical Education
    • Journal CME
    • Medical Education
  • Gastroenterology
    • Gastroenterology
  • Nutrition
    • Nutrition
    • Eating Disorders
  • Endocrinology
    • Metabolic Disorders
    • Endocrinology
  • Journal Info
  • Editorial Board
  • ABP Content Specifications Map
  • Overview
  • Licensing Information
  • Authors
  • Author Guidelines
  • Submit My Manuscript
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
American Academy of Pediatrics

© 2021 American Academy of Pediatrics