Characteristics of and weaning strategies in tube-dependent children

Pediatr Int. 2013 Apr;55(2):208-13. doi: 10.1111/ped.12030.

Abstract

Background: Despite resolution of the symptoms of eating and/or swallowing disorders, prolonged tube feeding is maintained in some children. This study summarized the characteristics of children with tube dependence and investigated the causes of tube dependence.

Methods: Clinical and growth data were evaluated using medical records and referral forms for 35 tube-dependent children.

Results: The children in this study had a median age of 30 months (range, 17-37 months) on the first visit and 35.5 months (range, 21.3-44.8 months) at tube removal. Seven children were not weaned from the feeding tube within the study period. Twenty-two (63%) of the children were girls, 20 (57%) were able to walk, 24 (69%) had mild mental retardation, and 33 (94%) had underlying disease. Tube-dependent children tended to weigh less than age-matched normal children. Sixteen children (45.7%) were underweight. Children who had their feeding tubes removed before age 3 were significantly younger at the initial visit than those who had their tubes removed after 3 years of age. Increased finger feeding was observed during the period before tube removal.

Conclusion: Tube-dependent children tend to be close to normal in body growth and intellectual development. When weaning from tube feeding, interventions at earlier ages are more efficient. Reduction in or discontinuation of tube feeding and encouragement of self-feeding were effective to wean off tube feeding.

MeSH terms

  • Child Development / physiology*
  • Child, Preschool
  • Deglutition / physiology*
  • Deglutition Disorders / rehabilitation*
  • Enteral Nutrition / methods*
  • Feeding Behavior / physiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Weaning*