Transitioning to oral feeding: A retrospective cohort study of a family‐centered, hunger‐based tube weaning program

Abstract

BackgroundWe investigated the effectiveness of a novel, hunger‐based outpatient tube weaning program for children with feeding‐tube dependency.MethodsThis interdisciplinary program induced hunger via rapid reduction in tube‐fed calories, followed by 2 weeks of daily outpatient mealtime support and regular follow‐up. Forty‐one children (6.9 months to 12.8 years) participated in this retrospective cohort study.ResultsBefore the program, children received a median of 90.0% (interquartile range [IQR]: 75.0%–100%) of caloric intake via tube feeds. At the end of the 2‐week program, children received 16.0% (IQR: 0.0%–30.0%) of caloric intake via tube feeds, which further reduced to 1.5% (IQR: 0.0%–33.0%) at 6‐months, and 0.0% (IQR: 0.0%–35.0%) at 1‐year follow‐up. The percentage of participants who ate >30 different foods increased from 4.9% at baseline to 81.5% at 1‐year follow‐up. The baseline median weight z score of −1.24 (IQR: −1.69 to −0.69) decreased to −1.81 (IQR: −2.77 to −1.02) at 1‐year follow‐up. A linear mixed‐effects model demonstrated that weight z score was significantly higher at baseline and 2‐weeks compared to the 1‐year follow‐up (P < 0.001 and P = 0.001, respectively), but was not significantly different between 6 months and 1 year (P = 0.44). Age was not associated with percentage of caloric intake via tube feeds or number of foods eaten.ConclusionChildren who participated in the hunger‐based tube‐weaning program had increased and more varied oral intake 1 year following the intervention. The median weight z score decreased over the year after intervention but did not significantly decrease between 6 and 12 months after the program.