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Rehabilitating oral feeding in children with chronic respiratory diseases and prolonged enteral nutrition is challenging but achievable. Over half of these patients successfully transition to some form of oral feeding, though it can be a lengthy process.

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Area of Science:

  • Pediatric Gastroenterology
  • Respiratory Medicine
  • Clinical Nutrition

Background:

  • Prolonged enteral nutrition (EN) poses challenges for oral feeding rehabilitation (OFR) in pediatric patients.
  • Children with chronic respiratory diseases often require long-term EN via nasogastric tubes (NGT) or gastrostomy tubes (GT).

Purpose of the Study:

  • To describe the process of oral feeding rehabilitation in children with chronic respiratory diseases requiring prolonged enteral nutrition.
  • To identify factors influencing the success of OFR in this specific pediatric population.

Main Methods:

  • Retrospective review of clinical records of children with EN exceeding two months.
  • Inclusion criteria: patients admitted between 2005 and 2014 with chronic respiratory conditions and NGT or GT.
  • Data analysis focused on demographics, diagnoses, feeding tube details, and OFR outcomes.

Main Results:

  • 116 children were included, with a median age of 10 months; 82.8% had tracheostomies.
  • The primary reason for EN was swallowing disorders (92.4%).
  • Of 42 patients indicated for OFR, 50% achieved exclusive oral feeding (higher success with NGT vs. GT, p=0.023), 14% partially, and 36% failed. The median time to exclusive oral feeding was 9.75 months.

Conclusions:

  • Oral feeding rehabilitation is a slow but feasible process in children with severe chronic respiratory diseases and prolonged EN.
  • A significant proportion (64%) of these children can achieve partial or complete oral feeding.
  • Success rates and timelines for OFR were not significantly influenced by age, sex, feeding tube type, EN duration, or neurological disease presence.