The following is a summary of “Observation of Child Experience During Discontinuing of Medically Provided Nutrition and Hydration,” published in the MARCH 2023 issue of Pain Management by Lazzara, et al.

In certain circumstances, medically provided nutrition and hydration (MPNH) for children is permitted according to ethical and professional standards; nonetheless, research indicated that many healthcare professionals opposed this practice. Clinicians’ concern for children’s suffering was one reason they continued MPNH. For a study, researchers sought to evaluate physician reports of newborn and child experiences after MPNH withdrawal or discontinuation.

The study was a nationwide survey of doctors who personally provided medical care for a baby or child while MPNH was being withheld or discontinued. Facebook, Twitter, and email were used to spread the survey. Analysis of the descriptive and content data was done.

Responses from 195 physicians reflected interactions with 900+ kids, with more than half of those interactions taking place in the previous year. 76% of instances involved consultation with palliative care. The majority of doctors stated that during the withholding or discontinuation of MPNH, patients’ feelings of comfort (80/142, 56%), tranquility (89/143, 62%), and dry lips/mouth (109/143, 76%) increased. Most people saw a decrease in respiratory secretions (90/142, 63%) and work of breathing (58/142, 63%). The perceived need for painkillers was frequently stable (54/142, 38%). The word “peaceful” was frequently used to characterize the dying process when MPNH was withheld or discontinued. The number of parents reporting relief (78/137, 57%), peace (77/137, 56%), and anxiety (74/137, 54%) increased, according to the clinics.

During the withholding or withdrawal of MPNH, most infants’ and children’s respiratory, gastrointestinal, and comfort complaints improved. Fewer than 10% of kids were thought to be experiencing greater symptom discomfort aside from dry lips/mouth. The results of the study were in line with data from adults, and they failed to discover a convincing argument against withholding or ceasing MPNH based purely on worries about children’s comfort.

Reference: jpsmjournal.com/article/S0885-3924(22)01031-4/fulltext