When children get acute pancreatitis (a painful swelling of the pancreas), doctors have traditionally used feeding tubes to give them nutrition while they recover. This new study compared 48 children who either ate regular food by mouth or received nutrition through a nose tube. Both groups recovered at about the same speed, with pain lasting about 3 days in each group. Interestingly, the children who ate normally had fewer complications and didn’t need the invasive feeding tube procedure. This suggests that letting kids eat regular food might be just as safe and effective as using feeding tubes, while being more comfortable and natural.

The Quick Take

  • What they studied: Whether children with mild to moderate pancreas inflammation recover better by eating regular food or by getting nutrition through a tube inserted through the nose into the stomach
  • Who participated: 48 children with acute pancreatitis (pancreas swelling) ranging from mild to moderately severe cases. The children were split into two equal groups of 24 each
  • Key finding: Both groups recovered similarly—pain lasted about 3 days for both. Kids who ate normally had no complications, while 4 kids in the tube-feeding group developed problems. Weight gain was similar in both groups after 5 weeks
  • What it means for you: If your child has mild to moderate pancreas inflammation, eating regular food appears to be just as effective as tube feeding for recovery, and it’s more comfortable. However, this is one study with a small group, so talk with your child’s doctor about what’s best for their specific situation

The Research Details

This was a randomized controlled trial, which is one of the strongest types of medical studies. Researchers followed 56 children with acute pancreatitis from September 2021 to August 2024 at a single hospital. The children were randomly assigned to either eat regular food by mouth or receive nutrition through a nasogastric (NG) tube—a thin tube that goes through the nose down to the stomach. Random assignment means the researchers used chance (like flipping a coin) to decide which group each child joined, which helps ensure the groups are similar and the results are fair.

The researchers measured three main things: how long the belly pain lasted, how well each child tolerated their feeding method, and whether they gained or lost weight. They checked on the children at discharge from the hospital and again at 1 week and 5 weeks after going home. They also watched for any complications or problems that developed in either group.

This type of study design is important because it lets researchers compare two different treatments directly in real children, rather than just observing what happens naturally. By randomly assigning children to groups, researchers can be more confident that any differences they find are due to the feeding method and not other factors.

This research matters because doctors have traditionally used feeding tubes for children with pancreas inflammation, assuming it was safer and better. However, feeding tubes are invasive (they go inside the body), uncomfortable, and can cause complications. If eating regular food works just as well, it would mean less discomfort for sick children and fewer medical procedures. This study provides evidence to help doctors make better decisions about how to feed children during pancreas recovery.

This study has several strengths: it’s a randomized controlled trial (the gold standard for comparing treatments), the groups were similar at the start, and researchers carefully tracked outcomes. However, there are some limitations to consider: the sample size is relatively small (48 children), it was conducted at only one hospital, and the follow-up period was relatively short (5 weeks). The study also had 8 children drop out before completion, which is fairly typical but worth noting. These factors mean the results are promising but should be confirmed with larger studies before making major changes to medical practice.

What the Results Show

The main finding was that both feeding methods worked similarly well. Children in the oral (regular eating) group and the NG tube group both experienced abdominal pain for a median of 3 days after admission to the hospital. This difference was not statistically significant, meaning it could have happened by chance.

Both groups tolerated their feeding method well, with no significant difference in tolerance rates between them. This means children in both groups were able to receive adequate nutrition without major problems.

Weight changes were nearly identical between groups. At hospital discharge, 1 week after discharge, and 5 weeks after discharge, there were no meaningful differences in weight between the two groups. Both groups showed slight weight increases by 5 weeks post-discharge, suggesting good recovery in both.

A notable finding was that the oral feeding group had no complications, while 4 children in the NG tube group developed complications. Although this difference wasn’t quite statistically significant (likely due to the small sample size), it suggests a potential advantage to regular eating.

The study found that baseline characteristics (starting conditions) were similar between groups, meaning the random assignment worked well. The causes of pancreatitis were also similar between groups, so any differences in outcomes weren’t due to different types of pancreas problems. The fact that both groups showed similar pain duration and weight recovery suggests that the pancreas inflammation resolved at similar rates regardless of feeding method. The absence of complications in the oral feeding group is particularly interesting and suggests that regular eating may be not just as safe, but potentially safer than tube feeding.

Historically, medical practice has favored nasogastric tube feeding for children with acute pancreatitis, based on the theory that bypassing the mouth and allowing the pancreas to rest would promote healing. However, recent research in both adults and children has challenged this assumption, suggesting that the pancreas can tolerate oral nutrition better than previously thought. This study adds to growing evidence that early oral feeding is beneficial and safe. It aligns with newer nutritional guidelines that emphasize starting nutrition as soon as tolerated, rather than waiting or using invasive methods. The findings support a shift toward more patient-friendly feeding approaches in pediatric pancreatitis care.

The study has several important limitations. First, it’s relatively small with only 48 children in the final analysis, which limits how confident we can be in the results. Second, it was conducted at only one hospital, so the results may not apply to all hospitals or all populations. Third, the follow-up period was only 5 weeks, so we don’t know about long-term outcomes. Fourth, the study only included children with mild to moderately severe pancreatitis, so results may not apply to children with very severe cases. Finally, 8 children dropped out of the study, which could have affected the results if those children had different outcomes than those who completed it.

The Bottom Line

Based on this study, oral feeding (regular eating) appears to be a reasonable option for children with mild to moderately severe acute pancreatitis, with similar outcomes to nasogastric tube feeding and potentially fewer complications. However, this recommendation comes with moderate confidence due to the small sample size. The decision should always be made in consultation with your child’s medical team, who can assess your child’s specific situation, severity of illness, and ability to tolerate oral feeding. For very severe cases, tube feeding may still be necessary.

This research is most relevant for parents of children with mild to moderately severe acute pancreatitis, pediatric gastroenterologists, pediatric intensivists, and hospital nutritionists. Children with very severe pancreatitis or those unable to tolerate oral feeding may still need tube feeding. This doesn’t apply to adults with pancreatitis, as their treatment may differ. If your child has been diagnosed with acute pancreatitis, discuss these findings with your child’s doctor to determine the best feeding approach for their specific case.

Based on this study, children in both groups experienced pain relief within about 3 days. Weight recovery and tolerance of nutrition occurred over the 5-week follow-up period. However, individual children may recover at different rates. Most children showed improvement within the first week, with continued weight gain over the following weeks. Expect gradual improvement rather than immediate dramatic changes.

Want to Apply This Research?

  • Track daily abdominal pain levels (using a simple 1-10 scale), daily food intake tolerance (what foods your child can eat without discomfort), and weekly weight measurements. Note any complications or concerning symptoms.
  • If your child has mild to moderate pancreas inflammation and their doctor approves oral feeding, the app can help you: (1) gradually introduce different foods as tolerated, (2) track which foods cause problems and which are well-tolerated, (3) monitor pain levels throughout the day to identify patterns, and (4) record weight trends to ensure adequate nutrition and recovery.
  • Create a daily log tracking: pain level before and after meals, specific foods eaten and how well they were tolerated, any symptoms or complications, and weekly weight. Set reminders for meal times and pain assessments. Share this data with your child’s healthcare team at follow-up appointments to monitor recovery progress and adjust the feeding plan as needed.

This research summary is for educational purposes only and should not replace professional medical advice. Acute pancreatitis in children is a serious medical condition requiring professional diagnosis and treatment. The feeding method for your child should be determined by their healthcare team based on the severity of their condition, their ability to tolerate oral feeding, and other individual factors. Always consult with your child’s pediatrician, gastroenterologist, or other qualified healthcare provider before making decisions about your child’s nutrition and treatment during pancreatitis. This study involved a small sample size at a single center, so results should be confirmed with larger studies before widespread implementation.