Lead Researcher – Sara Mancell
Sara Mancell of King’s College London and King’s College Hospital NHS Foundation Trust discusses her research and what it means for the nutritional management of children with biliary atresia.
Biliary atresia (BA) is a rare liver disease of the bile ducts. As bile from the bile ducts is needed to digest fat, babies with BA may not absorb enough fat and can become malnourished. To help prevent malnutrition and help babies to grow, medium-chain fat is given as an energy source. Medium-chain fat is a special fat that can be absorbed even when there is no bile available. It is incorporated into specialist formula milks and can also be added separately to formula milk or to expressed breast milk as an oil.
Even though medium-chain fats are used widely in the NHS there is no agreement on how much to give. Babies are given anywhere from 30% to 75% of their total fat intake as medium-chain fat with the remainder being regular fat.
This study involves giving babies with biliary atresia either low or high amounts of medium-chain fat for six weeks in the period after kasai portoenterostomy surgery. This will be done by adding a small amount of either regular fat (from safflower oil) or medium-chain fat (from coconut oil) to specialist formula milk. We will monitor weight, intake of formula milk and feeding tolerance during the study.
Why is this research important?
There has been little research on medium-chain fat supplementation in children with liver disease. This research will increase our understanding of medium-chain fat supplementation and provide the basis for developing a larger multicentre study.
What about the future?
Our aim is to carry out a future trial comparing growth and outcomes in babies receiving different amounts of medium-chain fats. This could improve the nutritional management and outcomes not just for children with biliary atresia but for all children with liver disease given medium-chain fat supplementation.