Call to find a provider

The Parenteral and Enteral Nutrition Support Clinic (PENS)

The Parenteral and Enteral Nutrition Support Clinic (PENS) at Children’s Hospital & Medical Center has been developed to provide centralized management of infants and children receiving some form of nutrition support.  The PENS Clinic is intended for infants, children and adolescents who require enteral and/or parenteral nutrition support regardless of their diagnosis.  Because the needs of this population can be complex, the clinic offers a multi-disciplinary team that includes a gastroenterologist, pediatric dietitian, registered nurse and social worker.  These professionals work together to ensure patients meet their nutritional needs and are medically stable to have a better quality of life.  The PENS team will manage the nutritional support needs of these patients on an ongoing basis and will provide follow-up care until no longer necessary.


The clinic goals include:

 To provide ongoing nutrition therapy that ensures daily macro- and micro-nutrient needs are met.

  • To promote a successful transition from parenteral nutrition to enteral nutrition.
  • To promote independence from nutrition support.

What is Parenteral Nutrition?

Parenteral nutrition, also referred to as total parenteral nutrition (TPN), provides nourishment to your child intravenously. 

What is Enteral Nutrition?

Enteral nutrition utilizes the GI tract to nourish your child and is provided through a tube placed either directly into the stomach or jejunum or into a tube placed in your child’s nose.  

What Happens to Oral Intake?

For those patients transitioning to oral food intake, treatment may also include on-going therapy sessions with occupational and speech therapists.


Patients receiving parenteral nutrition will generally require clinic visits every two-four weeks. Those receiving enteral nutrition will require visits every four to eight weeks depending on how stable they are.

Who Qualifies?

Patients need to meet at least one of the following criteria:

  • Patients who receive partial or total enteral nutrition support via feeding tube.
  • Patients who receive parenteral nutrition support.

The medical history of these patients will vary, but commonly patients will have histories of prematurity, aspiration, oral aversion, short bowel syndrome, bowel resection or developmental delay.


A patient must have a physician referral to be seen at the Parenteral and Enteral Nutrition Support Clinic (PENS). The referring physician must complete the PENS Clinic Referral Form and fax it in addition to any additional medical documentation to the attention of: PENS Clinic Nurse at 402-955-5720.

Additional documentation includes copies of the patient’s growth charts, information related to nutrition intake and relevant medical documentation such as diagnoses, current treatment plans and procedure history.

Clinic Staff:
Ruben Quiros, M.D., Clinical Service Chief
Fernando Zapata, M.D.
Kristy Anderson, MS, RD, LMNT
Amanda Beranek BSN, RN
Jenna Schaecher, PCMSW, PLMHP