A multidisciplinary intervention for weaning infants and toddlers from long term nasogastric (NG) and percutaneous endoscopic gastrostomy

Judy Blinder, Tal Dror, Maurit Beeri

Background

Children maintain their growth and development by ingesting adequate calories and essential nutrients, typically achieved via the oral intake of food and liquids. When infants and children are unable to eat or drink orally, they require temporary or permanent enteral nutritional support via nasogastric, nasoduodenal gastrostomy or jejunostomy tubes. 

Objective

The objective of this retrospective study was to illustrate lessons learned from the weaning program, which has been in operation at ALYN Hospital for over a decade. It took into consideration key patient population characteristics, including gender, age, diagnosis, type of tube feeding and manner of hospitalization. It further sought to identify those characteristics that correlated with the most successful weaning.

Results

Study data was obtained from the hospital’s secure medical database of 82 infants and toddlers. This comprised 37 boys (45.4%) and 45 girls (54.9%), aged three months to 10.8 years (mean age = 1.6 years, SD=1.9), enrolled in ALYN’s tube-feeding intervention program from 2011-2020. Fifty-one children (62.2%) were under two years of age, 26 children (31.7%) between 2 and 4.11 years, and five children aged five years and above (6.1%).

A total of 56 children were initially successfully weaned from tube feeding. A further nine children were eventually successful but took longer than anticipated. 11 children were partially weaned and six were not weaned at all. Younger children displayed significantly better results than older ones. These results are discussed within the context of a successful weaning program related to the participant’s characteristics (complexity of medical condition, age, gender and weight), as well as recommendations related to the intervention setting, duration and intensity, redefining success in weaning and the need for long-term follow-up.