Oral nutritional supplementation in paediatric feeding difficulties: a South African pharmacist’s evidence-based review

Abstract

Objective: This narrative review evaluates the evidence for oral nutritional supplementation (ONS) in paediatric patients with feeding difficulties, commonly known as picky eating, and emphasises the pharmacist’s role in identifying risk factors, guiding supplementation, and optimising nutritional outcomes.

Methodology: A comprehensive literature search was conducted using PubMed, Scopus, and the Cochrane Library through 2024, focusing on studies addressing the prevalence, causes, and consequences of picky eating in children and the clinical impact of ONS and pharmacist-led interventions.

Key findings: Picky eating is a prevalent issue in children and may contribute to nutritional deficiencies and growth concerns, particularly in low- to middle-income countries (LMICs), such as South Africa, where food insecurity and limited dietary diversity exacerbate the nutritional risk. Evidence suggests that, when used appropriately in at-risk populations, ONS can support catch-up growth, improve micronutrient status, and enhance appetite.

Key conclusions: Pharmacist-driven nutritional screening and ONS support, when targeted to high-risk populations, can be pivotal in mitigating paediatric malnutrition in LMICs like South Africa.