A multicomponent behavioral program for oral aversion in children dependent on gastrostomy feedings

J Pediatr Gastroenterol Nutr. 2003 Oct;37(4):473-80. doi: 10.1097/00005176-200310000-00014.


Objectives: Describe outcomes in nine children with Nissen fundoplication and feeding gastrostomy treated in a multicomponent feeding program. The importance of comprehensive evaluation, appetite regulation, and family-focused intervention within a behavioral feeding program are discussed.

Methods: Prospective clinical intervention with dependent measures evaluated before treatment, after treatment, and at follow-up.

Results: Nine children (4 girls; mean age, 3.1 +/- 1.2 years; range, 1.8-5.5 years) and their mothers were admitted for intensive treatment (mean duration, 11.4 +/- 1.7 days; range, 5-16 days). At discharge, 4 of 9 (44%) children were weaned completely from gastrostomy feedings. The mean oral intake of all patients increased 50% from pretreatment to posttreatment assessment. At a mean of 3.1 +/- 0.5 months (range, 2.4-3.6 months) after treatment, six of nine children were weaned completely from gastrostomy feedings. The percent of daily nutritional needs consumed orally increased from a pretreatment mean of 14.6% +/- 21.2% (range, 0%-67%) to a posttreatment mean of 63.4% +/- 18.3% (range, 34%-85%) and a follow-up mean of 88.1% +/- 25.1% (range, 30%-100%). The mean percent ideal body weight for height was not compromised during intensive treatment.

Conclusions: Short-term intensive biobehavioral treatment was successful in improving oral intake and weaning from gastrostomy tube feeding in children with Nissen fundoplication and feeding gastrostomy.

MeSH terms

  • Behavior Therapy*
  • Body Height
  • Body Weight
  • Child, Preschool
  • Enteral Nutrition*
  • Feeding and Eating Disorders / classification
  • Feeding and Eating Disorders / etiology
  • Feeding and Eating Disorders / therapy*
  • Female
  • Fundoplication*
  • Gastroesophageal Reflux / surgery
  • Gastrostomy*
  • Humans
  • Infant
  • Male
  • Prospective Studies