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Background Patients undergoing Haematopoietic Stem Cell Transplantation (HSCT) require enteral nutrition, due to the side effects of chemotherapy and treatment complications. The prescription of fibre-devoid hydrolysed formulas (HF) and amino-acid formulas (AAF) is standard practice for the management of gastrointestinal mucositis. Within this complex cohort, there is however, limited evidence to support these formulas over whole protein fibre-based formulas. Additionally, there is growing evidence to support the beneficial role of fibre in promoting a healthy gut microbiome, which may mitigate the gastrointestinal side effects of HSCT. Therefore, from June 2024, whole protein fibre-based formulas (WPFF) were prescribed as a first-line for patients undergoing a HSCT.Aim To compare the gastrointestinal tolerance and incidence of parenteral nutrition (PN) between whole protein fibre-based formulas with fibre-devoid HF and AAF during HSCT.Methods Data was collected retrospectively from EPIC on demographics, diagnoses, conditioning regimens, enteral formula type, and PN use from June 2023 to June 2025.Results 99 patients were included. 33 (33%) children received a WPFF, 44 (44%) received a HF, 21 (21%) received an AAF and 4 (4%) received a whole protein non fibre feed (4%). PN was required by 52 patients. The type of formula (fibre vs non fibre) did not impact the likelihood of PN in children who had Minimal-intensity (MIC) or Reduced Intensity conditioning (RIC): p=0.73. The type of formula did not affect the incidence of PN in children who had Myeloablative conditioning (MAC): p=0.07 .Fibre and AAF reduced the likelihood of PN in children who had MAC Reduced Toxicity: p=0.01.Conclusion WPFF are well tolerated during mucositis and do not increase PN incidence. Children receiving even MAC may tolerate fibre feeds during transplant and not require escalation to PN. Longer term data is needed to assess the clinical outcomes between fibre and non-fibre-based formulas.