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Related Experiment Videos

Helping children stop or avoid enteral feeding.

Charlotte Wright

    BMJ Quality Improvement Reports
    |January 7, 2016
    PubMed
    Summary

    A multidisciplinary feeding clinic successfully weaned 67% of children from tube or oral supplements, reducing feeding duration and demonstrating significant cost-effectiveness for the NHS.

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    Area of Science:

    • Pediatrics
    • Clinical Nutrition
    • Health Services Research

    Background:

    • Long-term enteral feeding is crucial for children unable to feed orally, but transitioning to a normal diet can be challenging.
    • Neurodisability can necessitate tube feeding later in childhood, yet identifying suitable candidates is complex.
    • The Royal Hospital for Sick Children, Yorkhill established a multidisciplinary feeding team to optimize care and minimize unnecessary tube feeding.

    Purpose of the Study:

    • To evaluate the effectiveness and cost-effectiveness of a multidisciplinary feeding clinic in managing complex pediatric feeding problems.
    • To reduce the duration of artificial feeding (enteral or oral supplements) in children.
    • To improve the overall care and outcomes for children with severe nutritional problems or those requiring artificial feeding.

    Main Methods:

    • A specialized team comprising a clinical psychologist, paediatric dietitian, and consultant paediatrician managed referred cases.
    • Inclusion criteria focused on artificially fed children or those with severe nutritional issues, following failed uni-disciplinary management.
    • Data collection involved tracking patient feeding status, duration of feeds, and outcomes post-intervention over a ten-year period.

    Main Results:

    • Over ten years, 67% of 222 patients transitioned from tube or oral supplement feeding to normal diets.
    • The median duration of tube feeding decreased significantly from seven years in the initial three years to 2.7 years subsequently.
    • Of 53 children referred for potential tube feeding, 60% remained on a normal diet, and only 19% required tube feeding.

    Conclusions:

    • A multidisciplinary feeding clinic is highly effective in weaning children from artificial feeding and improving dietary independence.
    • The service demonstrates significant cost-effectiveness, saving the National Health Service substantial resources by reducing feeding duration.
    • Early intervention and specialized, multidisciplinary care can optimize outcomes for children with complex feeding difficulties.

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