A retrospective chart review to assess feeding tolerance in children who had been switched from an intact protein formula to a Peptide based formula due to feeding intolerance in a pediatric facility for the developmentally delayed.

Medical records of pediatric patients with enteral feeding intolerance on standard polymeric formulas that were switched to a peptide based formula will be retrospectively analyzed. Data will be collected on caloric intake, ability to meet enteral nutrition goals, incidence of intolerance, and the use of medications to control gastrointestinal symptoms.

Inclusion Criteria:

• 13 months to < 18 years of age on admission to facility
• Required enteral nutrition to meet 90% or more of their energy needs prior to switch to a Peptide based formula
• Received enteral nutrition with an intact protein formula for a minimum of two weeks prior to a switch to a Peptide based formula
• Have documentation of intolerance to an intact protein formula, followed by a switch in formula received to a Peptide based formula
• Have documentation of an assessment of feeding tolerance following the switch to a Peptide based formula
• Formulas received must be indicated for use in children or adults (not infant formulas).

Exclusion Criteria:

• Recent abdominal surgery, change in tube position/placement (within past 30 days)
• Cow's milk protein allergy
• Any current infections including upper respiratory, viral, gastroenteritis, wound infection.

The population studied retrospectively will be pediatric patients with developmental delays dependent on enteral nutrition for 90% or more of their nutritional needs and meeting the inclusion/ exclusion criteria.

All data will be presented in manuscript