Withdrawing feeds from children on long term enteral feeding: factors associated with success and failure

Archives of Disease in Childhood
Charlotte WrightJill Morrison

Abstract

Enteral feeding is vital for sick infants, but the transition to normal diet may be difficult. The authors describe a feeding team which provides multidisciplinary management of 'hard to wean' children within a large children's hospital, using reduction of feed volume to stimulate hunger, combined with psychological input to improve mealtime interactions and relieve parental anxiety. To assess the impact of feed reduction on growth and identify factors associated with successful feed cessation. Clinical and anthropometric data retrieved from case notes and clinic database for all 41 children referred for feed withdrawal over a 5-year period. The children were aged median 4.0 (range 0.7-15) years when first seen; 27 (66%) were male and before reduction they received a median of 3766 (range 1987-9728) kJ daily from enteral feeds. Parents were often extremely anxious about weight loss and needed considerable support to make feed reductions. After follow-up for median (range) 1.7 (0.4-5.4) years, 32 (78%) were on solely normal diet, seven were still enterally fed and two were reliant on oral supplement drinks. Those referred after age 5 years were more likely to still be on artificial feeds (OR 7.4 (1.3-42); p=0.025) or to have tak...Continue Reading

Citations

Dec 22, 2015·The Journal of Pediatrics·Maireade E McSweeneyRachel Rosen
Dec 21, 2012·Pediatrics International : Official Journal of the Japan Pediatric Society·Akiko IshizakiYoshiharu Mukai
Jun 20, 2014·Journal of Paediatrics and Child Health·Sabine MarinschekPeter Scheer
Nov 8, 2014·Journal of Paediatrics and Child Health·David Forbes, Zubin Grover
Mar 27, 2015·Archives of Disease in Childhood·Charlotte M Wright, Anna Chillingworth
Aug 2, 2013·Archives of Disease in Childhood·Charlotte M Wright
Mar 21, 2015·JPEN. Journal of Parenteral and Enteral Nutrition·Sarah EdwardsPaul Hyman
Oct 21, 2016·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Wednesday Marie A Sevilla, Barbara McElhanon
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Sep 4, 2017·Archives of Disease in Childhood. Education and Practice Edition·Charlotte M Wright
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Aug 25, 2019·Current Gastroenterology Reports·Kim MilanoBenny Kerzner
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Aug 19, 2020·Journal of Pediatric Gastroenterology and Nutrition·Valeria DipasqualeDelphine Ley
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Sep 1, 2021·European Journal of Clinical Nutrition·Haude ClouzeauFrédéric Gottrand
Aug 31, 2021·Journal of Pediatric Rehabilitation Medicine·Hikari FukatsuTakayoshi Sakai

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