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Reinstituting oral feedings in children fed by gastrostomy tube
Insights
Children with gastrostomies can resume oral feeding if their underlying health issue is resolved. However, reintroducing oral intake may cause resistance and risks like aspiration, necessitating careful patient selection and management.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Swallowing Disorders
Background:
- Gastrostomy tubes are common interventions for children unable to feed orally.
- Transitioning back to oral feeding is a critical step in recovery.
- Potential challenges include child resistance and aspiration risks.
Observation:
- Seventeen children with existing gastrostomies were assessed for readiness for oral feeding.
- Only 10 children met the criteria for attempting oral intake.
- Management strategies were implemented for both inpatient and outpatient settings.
Findings:
- Successful oral feeding was achieved in 9 out of 10 selected children.
- One child with dysphagia aspirated, leading to discontinuation of oral feedings.
- Careful selection of candidates and tailored management are crucial for success.
Implications:
- Appropriate patient selection significantly increases the likelihood of successful oral feeding transitions.
- Early identification and management of potential complications like aspiration are vital.
- This study highlights the importance of individualized care plans for children with gastrostomies.
Abstract:
Children with gastrostomies may return to oral feedings provided the health problem which led to its placement has resolved, stabilized, or been corrected. However, attempts to accomplish this are likely to be met with resistance from the child, including gagging, choking, biting, and vomiting. Aspiration and even fatal airway obstruction are possible. Seventeen children with gastrostomies were evaluated to determine appropriateness for oral feedings. Only 10 of this group were deemed acceptable candidates. Five were managed successfully as outpatients and four as inpatients. One patient with dysphagia aspirated, and oral feedings were discontinued. Selection criteria and management methods are described.