Feeding Recovery in Post-PICU Patients: A Case Series in an Intensive Feeding Program
Tariq Almanaseer1, Ellen Hayhurst1, Jessica B Doorn2
1College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA.
Nutrients
|May 4, 2026
Summary
Pediatric intensive care unit (PICU) survivors showed significant feeding improvements after intensive interdisciplinary behavioral treatment (IIBT). Over half became eligible for tube weaning, highlighting IIBT
Area of Science:
- Pediatric critical care medicine
- Pediatric gastroenterology
- Pediatric rehabilitation
Background:
- Pediatric intensive care unit (PICU) survival has improved, but many children develop post-intensive care syndrome in pediatrics (PICS-p).
- PICS-p often includes persistent feeding difficulties, impacting growth and quality of life.
- Intensive feeding programs (IFP), or intensive interdisciplinary behavioral treatment (IIBT), can reduce tube dependence and improve oral intake, but outcomes in PICU survivors need further study.
Purpose of the Study:
- To evaluate feeding outcomes in children with prior PICU admission who completed an intensive interdisciplinary behavioral treatment (IIBT) program.
- To assess improvements in oral intake, feeding behaviors, and nutritional status post-IIBT.
Main Methods:
- Retrospective case series of 16 children (0-18 years) admitted to HDVCH, Corewell Health, Grand Rapids, Michigan, who completed IIBT between 2007 and 2024.
- Data collected included demographics, PICU course (admission cause, complications, length of stay, ventilation, nutrition status), and IIBT outcomes (feeding modality, oral skills, malnutrition).
- Feeding outcomes were compared pre- and post-IIBT.
Main Results:
- Following IIBT, 58% of previously tube-fed patients became eligible for tube removal, and 44% transitioned to partial or full self-feeding.
- Problematic mealtime behaviors decreased significantly (45.7% to 9.9%), while oral acceptance (62% to 95%) and mouth clearance (59% to 96%) improved.
- Malnutrition prevalence decreased from 20% to 12% post-IIBT.
Conclusions:
- Children with prior PICU admission demonstrated substantial improvements in feeding and behavior during IIBT.
- Over half of participants achieved tube-weaning eligibility, indicating the program's effectiveness.
- Significant delays between PICU discharge and IIBT initiation suggest potential barriers to timely intervention.
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