Intestinal Failure in Infants: Managing the Transition From Total Parenteral Nutrition
A Case-Based Program

Mark Corkins, MD, and Anna Featherston Tuttle, MS, RD, LDN, CNSC, provide an overview of intestinal failure (IF) in infants and a detailed, case-based discussion of nutrition management. Topics include causes and outcomes of IF, nutrition goals, assessment of infants with IF, pharmacotherapeutic options, and nutritional management. Practical recommendations for initiating and then weaning from parenteral to enteral nutrition are discussed, alongside the key guiding principles of maximizing enteral feeds in infants with short bowel syndrome and other forms of IF.

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  Mark R. Corkins, MD, CNSC

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  Mark R. Corkins, MD, is division chief of pediatric gastroenterology and professor of pediatrics at the University of Tennessee Health Science Center/Le Bonheur Children’s Hospital in Memphis, Tennessee. He holds the St. Jude Endowed Chair for Excellence in Pediatric Gastroenterology and is a consultant to St. Jude Children’s Research Hospital.

  Dr. Corkins received his medical degree from the University of Missouri-Columbia School of Medicine. He completed a pediatric residency at the University of Iowa Hospital and Clinics and a joint fellowship in pediatric gastroenterology at the University of Nebraska Medical Center/Creighton University in Omaha, Nebraska. Dr. Corkins is board certified in pediatrics, pediatric gastroenterology, and he is a certified nutrition support clinician.

  Upon joining Le Bonheur Children’s Hospital, Dr. Corkins expanded the pediatric gastroenterology program’s research, teaching, and clinical components. Under his leadership, the hospital instituted a gastroenterology fellowship program and added specialized clinics to increase access for infants, children, and adolescents with digestive, liver and nutritional issues, and to create a more coordinated plan of care. As an example, for children with short bowel issues, a clinic now offers access to a gastroenterologist, a surgeon, a dietitian, and a pharmacist, all in one setting. This clinic was named a Clinical Nutrition Team of Distinction by the American Society for Parenteral and Enteral Nutrition, an honor recognizing excellence in interdisciplinary clinical nutrition practice.

  The specialized clinics have also allowed the division to expand its research efforts. Le Bonheur is home to The Morgan Foundation, which supports the research of primary sclerosing cholangitis, a rare liver disease. Other current research projects include the national ImproveCareNow network for inflammatory bowel diseases, and research focused on gaining a better understanding of eosinophilic esophagitis.

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  Mark R. Corkins, MD, CNSC

  St. Jude Chair of Excellence in Pediatric Gastroenterology
  Division Chief of Pediatric Gastroenterology, Hepatology and Nutrition
  The University of Tennessee Health Science Center
  Pediatric Gastroenterology, Hepatology and Nutrition
  Memphis, Tennessee

• Profile

  Anna Featherston Tuttle, MS, RD, LDN, CNSC

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  Anna Featherston Tuttle, RD, is a clinical dietitian at LeBonheur Children’s Hospital in Memphis, Tennessee. Ms. Tuttle earned an MS degree in clinical nutrition at the University of Memphis, and her extensive experience includes clinical, community, sports, pediatric and long-term care nutrition, as well as school and hospital food service.

  Ms. Tuttle is a member of a multidisciplinary team providing nutrition support in the outpatient gastrointestinal clinic and for following patients on admission to the hospital. The gastroenterology clinic features subspecialty components designed to address conditions such as eosinophilic esophagitis, inflammatory bowel disease, liver transplants and pediatric intestinal rehabilitation. Ms. Tuttle is responsible for educating patients and their caregivers on specialized diets developed for a patient’s specific medical condition and for providing instruction on both oral and tube feeding. According to the prestigious US News & World’s Best Hospitals Awards, LeBonheur’s pediatric gastroenterology and GI surgery programs are ranked among the best nationwide.

  Ms. Tuttle is a member of a number of nutritional and dietetic organizations, serving on committees for several of them. She is the author or co-author of articles and book chapters on pediatric nutrition for healthcare professionals, as well as a frequent speaker on the topic.

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  Anna Featherston Tuttle, MS, RD, LDN, CNSC

  Registered Dietitian Nutritionist
  Certified Nutrition Support Clinician
  LeBonheur Children's Hospital
  Memphis, Tennessee