CHIRP Clinic

Children’s Hospital Intestinal Rehabilitation Clinic (CHIRP) Provides Multidisciplinary Care to Children on IV Nutrition

Infants and children on IV nutrition or home TPN (Total Parenteral Nutrition) often require the care of pediatric specialists across a variety of disciplines. The Children’s Hospital Intestinal Rehabilitation Clinic (CHIRP) at the Children’s Hospital of Michigan currently provides care to approximately 60 children, including 30 on home TPN.

Joseph L. Lelli, Jr., M.D. serves as medical/ surgical director of the clinic in addition to his roles as Surgeon-in-Chief of Pediatric Surgery at the hospital. The clinic provides integrated, multidisciplinary care from a pediatric surgeon, gastroenterologist, pharmacist, dietitian, social worker, physical therapist, occupational therapist and nurse practitioner.

Children dependent on IV nutrition can face liver problems, as well as growth and bone mineralization issues. Many children do not enter puberty naturally and require specialized care from an endocrinologist. Some children with little or no bowel will eventually require a bowel transplant.

“Ideally, we want to move children from TPN to enteral feeding. In a child with very little functioning bowel, this can be very difficult,” says Dr. Lelli . “But it’s important to minimize TPN and maximize enteral feeding. This protects the liver and may delay the need for a bowel transplant. Based on research, we know that children who have bowel transplants when they are older tend to have better outcomes.”