Transition from tube feeding to oral feeding: experience in a tertiary care paediatric cardiology unit

Abstract

Background

Home enteral tube feeding (HETF) is imperative for many infants and children with congenital heart disease (CHD). Tube weaning (TW) facilitates the progression from tube feeding to oral diet. There is limited literature on TW practices, protocols and success for children with CHD that have been tube fed.

Aims

The objective of this study is to assess the process of weaning HETF in a tertiary referral centre for paediatric CHD. Specifically, we aimed to assess the duration of HETF, duration of TW and the interventions involved.

Methods

We retrospectively reviewed the medical and dietetic records of all infants and children that were successfully weaned off HETF over a 12-month period from January 2015 to December 2015.

Results

There were 30 children included in the study, 9 boys and 21 girls. The diagnoses included 15 septal defects, 8 univentricular diagnosis and other diagnoses in 7 children. The median age at initiation of enteral tube feeding was 45 days (range 2–169). The median duration to wean from enteral tube feeding was 52 days (range 2–359). Number of dietetic consults required for successful TW varied among patients, median 5 (range 2–23). The number of days required for successful TW was associated with age and duration on HETF. Dietetic interventions included discontinuation of nutrient dense feeds, altering feed schedule and reduction of feed volume.

Conclusions

Weaning HETF is possible in the outpatient setting. Early and frequent dietetic intervention is recommended to ensure prompt discontinuation of HETF when appropriate.

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Affiliations

Authors

Corresponding author

Correspondence to Anne Marie Shine.

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Conflict of interest

The authors have no conflicts of interest relevant to this article to disclose.

Informed consent

This study complied with guidelines from Our Lady’s Children’s Hospital Ethical Committee. Informed consent was not obtained as this was a retrospective observational study.

Additional information

The original version of this article was revised: The original version of this article inadvertently used early drafts of Figures 1 and 2. Also, The correct affiliation of Dr. Daragh Gerard Finn and Dr. Colin J McMahon is Department of Paediatric Cardiology, Our Lady’s Children’s Hospital Crumlin, Crumlin, Dublin 12, Ireland.

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Shine, A.M., Finn, D.G., Allen, N. et al. Transition from tube feeding to oral feeding: experience in a tertiary care paediatric cardiology unit. Ir J Med Sci 188, 201–208 (2019). https://doi.org/10.1007/s11845-018-1812-3

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Keywords

  • Congenital heart disease
  • Home enteral tube feeding
  • Tube dependency
  • Tube dependent
  • Tube feeding
  • Tube weaning