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Weaning children from tube to oral feeding
1Department of Pediatric Neurosurgery, Hôpital des Enfants, La Timone, Marseille, France.
Insights
A novel sensory stimulation technique helps infants overcome prolonged tube feeding challenges. This method re-establishes oral feeding by stimulating the oropharyngeal cavity and regulating circadian rhythms, leading to faster recovery and shorter hospital stays.
Area of Science:
- Neonatology
- Neuroscience
- Pediatrics
Background:
- Prolonged tube feeding (over 15-20 days) can impede oral feeding resumption in infants.
- Infants recovering from underlying conditions may face significant difficulties re-establishing oral feeding after extended tube dependence.
Purpose of the Study:
- To introduce and evaluate a novel procedure for facilitating oral feeding in infants with a history of prolonged tube feeding.
- To assess the efficacy of sensory oropharyngeal stimulation and circadian rhythm regulation in promoting oral feeding.
Main Methods:
- The proposed procedure involves sensory stimulation of the oropharyngeal cavity.
- Stimulations are applied during tube feeding at regular intervals to re-establish the biological clock (circadian rhythm).
- Family involvement is integrated into the intervention.
Main Results:
- Oral feeding was successfully re-established in 19 infants experiencing difficulties after the intervention.
- The procedure led to a shorter time to oral feeding and reduced hospital stays.
Conclusions:
- Sensory oropharyngeal stimulation combined with circadian rhythm regulation is an effective method for overcoming oral feeding difficulties in infants.
- Adherence to swallowing neurophysiology and biological rhythms, with family support, optimizes outcomes for infant feeding rehabilitation.
Abstract:
Most of the children seen by specialists in neonatalogy, neuropaediatrics or neurosurgery do not have any problems in starting with oral feeding after a period of tube feeding lasting between 15 and 20 days. Children who have been tube fed for a longer period, however, can find it very difficult or even impossible to re-establish oral feeding when they have sufficiently recovered from their underlying problem. To cope with this situation we propose a procedure based on the afferentation or re-afferentation of the oropharyngeal cavity by sensory stimulations and by re-establishment of the biological clock (circadian rhythm) by applying these stimulations during tube feeding at regular hours. In 19 children who showed difficulties oral feeding became possible a short time after such a procedure had been applied. If the principles of swallowing neurophysiology and the biological rhythm are respected, this procedure, which also involves a contribution from the family, leads to quicker oral feeding and shorter stay in hospital.