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Transitioning to oral feeding: A retrospective cohort study of a family-centered, hunger-based tube weaning program

Rochelle H Stokes1, Anna L Willms2, Heather K Cowie2

  • 1BC Children's Hospital, Vancouver, British Columbia, Canada.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|October 23, 2024
PubMed

Insights

This study shows a hunger-based tube weaning program significantly increases oral intake and food variety in children dependent on feeding tubes. One year after the program, children consumed more food orally, with improvements in diet diversity.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Feeding Disorders

Background:

  • Feeding-tube dependency is a significant challenge in pediatric care.
  • Novel interventions are needed to improve oral feeding in dependent children.

Purpose of the Study:

  • To evaluate the effectiveness of a novel hunger-based outpatient tube weaning program.
  • To assess changes in oral intake, food variety, and nutritional status post-intervention.

Main Methods:

  • A retrospective cohort study involving 41 children with feeding-tube dependency.
  • The program involved rapid caloric reduction via tube feeds, followed by intensive outpatient meal support.
  • Daily outpatient support and regular follow-up were provided for 2 weeks.

Main Results:

  • Tube-fed caloric intake decreased from 90% at baseline to 1.5% at 6 months and 0% at 1 year.
  • The percentage of children eating >30 foods increased from 4.9% to 81.5% at 1 year.
  • Weight z-score decreased significantly from baseline to 1-year follow-up, but not between 6 and 12 months.

Conclusions:

  • The hunger-based tube weaning program effectively increased oral intake and food variety in children.
  • While weight z-scores initially decreased, they stabilized between 6 and 12 months post-intervention.
  • This program offers a viable strategy for managing pediatric feeding-tube dependency.
Abstract

Keywords:
enteral nutritionnutritionnutrition support practicenutrition support teamspediatric feeding disorderspediatrics

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