Short Bowel Syndrome (SBS), Total Parenteral Nutrition and Neocate

Posted 1.11.11 | Mallory West

Short bowel syndrome and TPN can be overwhelming at times for parents and caregivers. If your little one is struggling we hope that the following information will be helpful for both of you.

Short bowel syndrome (SBS) is a digestive disorder that occurs when a significant portion of the intestinal tract does not function properly. It usually occurs as a result of surgery to remove a significant portion of the intestinal tract. In infants, this surgery may be needed due to necrotizing enterocolitis (a condition that occurs in premature infants and leads to the death of bowel tissue) or congenital bowel defects (such as midgut volvulus, omphalocele or gastroschisis).

Total Parenteral Nutrition (TPN)

Infants with SBS cannot absorb enough water, vitamins, and other nutrients from breast milk or formula to live. The main treatment is nutritional support. At first, total parenteral nutrition or TPN (where nutrition is delivered directly into the blood stream) is usually required because nutrients can’t be absorbed in the GI tract. There are many risks and complications associated with TPN so its best to minimize the amount of time spent on TPN. The hope is that with time, the gut will adapt by growing longer, increasing its ability to absorb nutrients and digest formulas and foods normally.

Gut Adaptation

Gut adaptation is required in order to wean off TPN. It's crucial to introduce enteral nutrition (where liquid food is delivered to the GI tract rather than the blood stream) as early as possible. Patients may receive enteral nutrition or begin normal eating even though most of the nutrients are not absorbed and they continue to get most of their nutrition through TPN. Beginning enteral nutrition and normal eating stimulate the remaining intestine to function better. As the GI tract adapts and begins to function better, patients can be gradually transitioned off TPN. TPN cannot be totally stopped until the patient is able to tolerate enteral feeds and/or normal eating in quantities that can sustain all their calorie and nutritional needs.

Neocate Helps to Wean Off TPN Sooner

Because Neocate is an elemental formula, it is easy for the gut to digest and absorb. Studies show that beginning enteral nutrition using Neocate allows babies to come off of TPN sooner[1],[2]. This is important because the longer a patient remains on TPN, the greater the risk for serious complications, such as life-threatening infections or liver dysfunction. Once off TPN, the special formulation of Neocate provides all the nutrition that a baby/child with SBS needs to grow and develop properly while their guts continue to adapt.

Do any of you have little ones with SBS who use Neocate? We’d love to hear your stories!


[1] De Greef E, Mahler T, Janssen A, Cuypers H, Veereman-Wauters G. The Influence of Neocate in Paediatric Short Bowel Syndrome on PN Weaning. J Nutr Metab. 2010;2010.

pii: 297575. Epub 2010 May 31.

[2] Bines J, Francis D, Hill D. Reducing parenteral requirement in children with short bowel syndrome: impact of an amino acid-based complete infant formula. J Pediatr Gastr Nutr. 1998;26(2):123-128

Read Comments (4)

  • 2011-05-23 | Kathleen

    My son has SBS and uses Neocate!!! I believe it saved his liver, saved his life! He was able to wean off TPN at 8months old because of Neocate. He is now 21months old and is still on continuos drip feedings of neocate formula. I can’t thank you enough for my babies life smile

  • 2011-05-23 | Neocate Admin

    Thank you so much for your comment Kathleen!  We are so happy to hear how well your little one is doing!

  • 2015-03-30 | Vanessa

    My daughter was in the NICU until she was 6 months old. She was on breast milk until 8 months when we started Neocate. When we left the hospital she could only tolerate 2 oz of breast milk a day, since she’s been on Neocate, she is up to 26 oz! She just turned 13 months and we are finally weaning TPNs. While in the NICU she was on 24 hr TPN even with the breast milk and now 10 hrs of TPN & 20 hrs of Neocate! She hates the way it tastes but her belly has never worked better! Also she had to be continuously vented through a tube in her stomach until we switched to the formula, that no longer happens thank God!!

  • 2015-03-31 | Nutrition Specialist

    Hi Vanessa,
      Thanks so much for sharing your story! We’re so glad to hear that Neocate has been a helpful part of your daughter’s recovery. It’s not unusual for an infant to outgrow the taste of Neocate Infant. Since she’s past her first birthday, you could ask her healthcare team for their thoughts on adding a small amount of a flavored Neocate Junior to Neocate Infant to help her with taste acceptance.
      Best of luck to you all!

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Food Allergy Living is a resource for parents of children with food allergies, brought to you by Nutricia, the makers of Neocate. For more in-depth information about our purpose & authors, see our About Food Allergy Living page.