Successful Gastrostomy Tube Weaning Program Using an Intensive Multidisciplinary Team Approach

Brown, Jessica; Kim, Cindy; Lim, Audrey; Brown, Shonda; Desai, Hema; Volker, Leigh; Katz, Mitchell

doi:10.1097/mpg.0000000000000336

Cited by 52 publications

(18 citation statements)

References 17 publications

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“…Several studies use reducing or discontinuing tube feeding for appetite stimulation as a weaning method [4, 7, 20, 21, 39]. Various hunger-inducing weaning programs exist internationally, which may be home based [26, 38] or clinical [4, 7, 20]. However, there is limited literature regarding the efficacy and safety of these programs [17].…”

Section: Tube Weaning Methodsmentioning

confidence: 99%

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Development, prevention, and treatment of feeding tube dependency

2017

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Enteral nutrition is effective in ensuring nutritional requirements and growth. However, when tube feeding lasts for a longer period, it can lead to tube dependency in the absence of medical reasons for continuation of tube feeding. Tube-dependent children are unable or refuse to start oral activities and they lack oral skills. Tube dependency has health-, psychosocial-, and economy-related consequences. Therefore, the transition to oral feeding is of great importance. However, this transition can be very difficult and needs a multidisciplinary approach. Most studies for treatment of tube dependency are based on behavioral interventions, such as family therapy, individual behavior therapy, neuro-linguistic programming, and parental anxiety reduction. Furthermore, oral motor therapy and nutritional adjustments can be helpful in tube weaning. The use of medication has been described in the literature. Although mostly chosen as the last resort, hunger-inducing methods, such as the Graz-model and the Dutch clinical hunger provocation program, are also successful in weaning children off tube feeding. Conclusion: The transition from tube to oral feeding is important in tube-dependent children but can be difficult. We present an overview for the prevention and treatment of tube dependency. What is known: • Longer periods of tube feeding can lead to tube dependency. • Tube weaning can be very difficult. What is new: • Weaning as soon as possible and therefore referral to a multidisciplinary team are recommended. • An overview of treatment options for tube dependency is presented in this article.

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Section: Tube Weaning Methodsmentioning

confidence: 99%

“…At discharge, 90% and after a year 83% of 30 patients (ages 3.9 ± 1.4 years) had discontinued gastrostomy tube feedings [4]. …”

Section: Medicationmentioning

confidence: 99%

Development, prevention, and treatment of feeding tube dependency

2017

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“…Tube feeding can be a life-saving treatment strategy in the setting of acute malnutrition, but, in most cases, should be considered a temporary measure to support the ultimate treatment goal of obtaining adequate nutrition through oral intake. Once patients have gained to a healthy weight and can take in at least some nutrition by mouth, weaning off tube feeds is typically done under close supervision in an inpatient (24) or day treatment (25) setting.…”

Section: Treatmentmentioning

confidence: 99%

Evaluation and Treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents

et al. 2018

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Purpose of review: Avoidant/restrictive food intake disorder (ARFID) was added to the psychiatric nomenclature in 2013. However, youth with ARFID often present first to medical— rather than psychiatric—settings, making its evaluation and treatment relevant to pediatricians. Recent findings: ARFID is defined by limited volume or variety of food intake motivated by sensory sensitivity, fear of aversive consequences, or lack of interest in food or eating, and associated with medical, nutritional, and/or psychosocial impairment. It appears to be as common as anorexia nervosa and bulimia nervosa and can occur in individuals of all ages. ARFID is heterogeneous in presentation and may require both medical and psychological management. Summary: Pediatricians should be aware of the diagnostic criteria for ARFID and the possibility that these patients may require medical intervention and referral for psychological treatment. The neurobiology underlying ARFID is unknown, and novel treatments are currently being tested.

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“…Therefore, intensive multidisciplinary pediatric feeding programs composed of a team of therapists, psychologists, nurses, and physicians have become an established strategy for treating pediatric feeding disorders. [3][4][5] Medical diagnoses that have been associated with FR behaviors include gastroesophageal reflux disease (GERD), oropharyngeal dysphagia with swallowing difficulties, placement of a gastrostomy tube in early infancy, cardiorespiratory disease, and neurologic disease. 1,3,6 Although data are limited, food allergy has also been associated with feeding disorders in some studies.…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Food Allergies in Children Referred to a Multidisciplinary Feeding Program

Yeung¹,

Taylor

Scheimann³

et al. 2015

Clin Pediatr (Phila)

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Successful Gastrostomy Tube Weaning Program Using an Intensive Multidisciplinary Team Approach

Abstract: Children who are GT dependent can be weaned off GT feedings during a 3-week admission using a multidisciplinary feeding model. The therapeutic gains were maintained at 1 year postdischarge.

Cited by 52 publications

References 17 publications

Development, prevention, and treatment of feeding tube dependency

Development, prevention, and treatment of feeding tube dependency

Evaluation and Treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents

The Prevalence of Food Allergies in Children Referred to a Multidisciplinary Feeding Program

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