Oral nutrition support in adults

Adults who cannot eat enough to meet their daily nutritional requirements may need oral nutrition support (eg dietary modification, food fortification, nutritional supplements).

Consider the indication, risks, benefits and goals of nutrition support before starting oral nutrition support; these should be reviewed regularly while the patient is receiving oral nutrition supportNational Institute for Clinical Excellence (NICE), 2006. In patients with advanced dementia, decisions about oral feeding should routinely involve development (or review) of a holistic advance care plan, in consultation with substitute health decision makers. Patients with advanced dementia may benefit from speech pathologist referral for assessment of swallowing and feedingGuideline Adaptation Committee, 2016.

Oral nutrition support is appropriate only if the patient can swallow safely and their gastrointestinal tract is functioning.

Oral nutritional supplements are available as ready-to-drink formulations or powders for reconstitution, and come in a range of concentrations. Some specialised formulations are available for use in certain medical conditions (eg diabetes, kidney or liver disease) and for patients who have malabsorption or impaired wound healing. See product information for supplement constituents and recommendations for use.

Patients requiring oral nutrition support should be supervised by an accredited practising dietitian to optimise nutritional intake and ensure appropriate use of supplements. Patients receiving oral nutrition support in the community should be monitored for refeeding syndrome and have their nutritional and clinical status monitored regularlyNational Institute for Clinical Excellence (NICE), 2006. Oral nutrition support can be stopped when the patient’s weight has stabilised and they have adequate oral intake from normal foodNational Institute for Clinical Excellence (NICE), 2006.

In Australia, patients treated in the public health system may be able to access oral nutritional supplements at a reduced cost. Consult an accredited practising dietitian for information on eligibility criteria.