Table 3.

Nutritional and gastrointestinal management in children with spinal muscular atrophy

Issue	Evidence
Tube feeding	High probability (type 1 and 2)
Energy needs	Meet DRI
Formula	No special diet or formula
ONS	Possible (type 3 and 4); consider a speech-language therapist evaluation
Gastroesophageal reflux	Proton pump inhibitors; consider hydrolyzed or natural food enteral formulas
Constipation	PEG; consider hydrolyzed or natural food enteral formulas
Delayed gastric emptying	Meet fiber and fluid needs; prokinetics may be used

DRI: Daily recommended intake; ONS: Oral nutrition supplements; PEG: Polyethylene glycol.