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Weight and length increases in children after gastrostomy placement
D S Corwin1, J S Isaacs, K E Georgeson
1Dietitian Associates, Inc., Cordova, Tenn, USA.
Insights
Gastrostomy surgery aids catch-up growth in children with failure to thrive, especially nonambulatory ones. Adequate nutrition post-surgery is key for successful weight and height development.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Support
- Growth and Development
Background:
- Failure to thrive (FTT) is a significant concern in pediatric care.
- Gastrostomy (G-tube) feeding is a common intervention for FTT when oral intake is insufficient.
- Understanding post-G-tube growth patterns is crucial for optimizing patient outcomes.
Purpose of the Study:
- To document catch-up growth in children during the first 18 months after gastrostomy surgery.
- To analyze how weight and length growth vary based on medical and nutritional risk factors.
Main Methods:
- A repeated measures study evaluated weight and linear growth in 75 children diagnosed with FTT before gastrostomy placement.
- Measurements of weight and length were taken at surgery, and 12 and 18 months post-surgery.
- Paired t-tests and ANOVA were used to assess catch-up growth and identify predictors.
Main Results:
- Children demonstrated catch-up growth in height and weight post-gastrostomy, irrespective of prematurity or age at placement.
- Nonambulatory children achieved catch-up growth, unlike their ambulatory peers.
- Children with cerebral palsy showed improved growth compared to other diagnoses.
Conclusions:
- Gastrostomy surgery, coupled with adequate nutrition, can effectively correct failure to thrive in children up to age 6.6 years.
- The study highlights the critical role of medical nutrition therapy and gastrostomy feeding in promoting catch-up growth.
- Gastrostomy placement is an important intervention for improving nutritional status and growth in specific pediatric populations.
Objective:
To document catch-up growth in children in the first 18 months after gastrostomy surgery and characterize how weight and length growth differ according to medical and nutritional risks.
Design:
Repeated measures study to evaluate weight and linear growth in gastrostomy-fed children.
Subjects/Setting:
Seventy-five subject met the selection criteria; gastrostomy placement anytime from birth to age 6.5 years, diagnosis of failure to thrive before gastrostomy. surgery, absence of nonmedical barriers to adequate nutrition. Children were seen in specialty outpatient clinics.
Outcome Measures:
Three measurements of weight and length: at the time of surgery and 12 and 18 months after surgery.
Statistical Analyses:
Paired t tests of z scores were used to determine catch-up growth. Analysis of variance used variables (age of placement, ambulatory status, prematurity, mode of feeding) to determine statistically significant predictors of growth.
Results:
After gastrostomy surgery, catch-up growth was observed in height and weight for children regardless of prematurity or age at the time of gastrostomy placement. Ambulatory children did not achieve catch-up growth, but nonambulatory children did. At 18 months after surgery, catch-up growth occurred in children whose sole source of nutrition was through occurred in children whose sole source of nutrition was through the gastrostomy, as well as in those who were able to receive nutrition by mouth. Children with a diagnosis of cerebral palsy experienced better growth than children with other diagnoses. CONCLUSION/APPLICATION: Failure to thrive in children up to age 6.6 years can be corrected when adequate nutrition is provided. Benefits of gastrostomy surgery observed in catch-up growth reinforce the importance of medical nutrition therapy.