title: Weaning children from tube to oral feeding.
abstract: Most of the children seen by specialists in neonatalogy, neuropaediatrics or neurosurgery do not have any problems in starting with oral feeding after a period of tube feeding lasting between 15 and 20 days. Children who have been tube fed for a longer period, however, can find it very difficult or even impossible to re-establish oral feeding when they have sufficiently recovered from their underlying problem. To cope with this situation we propose a procedure based on the afferentation or re-afferentation of the oropharyngeal cavity by sensory stimulations and by re-establishment of the biological clock (circadian rhythm) by applying these stimulations during tube feeding at regular hours. In 19 children who showed difficulties oral feeding became possible a short time after such a procedure had been applied. If the principles of swallowing neurophysiology and the biological rhythm are respected, this procedure, which also involves a contribution from the family, leads to quicker oral feeding and shorter stay in hospital.
authors.affiliation: Department of Pediatric Neurosurgery, Hôpital des Enfants, La Timone, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Senez
authors.forename: J M
authors.initials: JM
authors.lastname: Guys
authors.forename: J
authors.initials: J
authors.lastname: Mancini
authors.forename: A
authors.initials: A
authors.lastname: Paz Paredes
authors.forename: G
authors.initials: G
authors.lastname: Lena
authors.forename: M
authors.initials: M
authors.lastname: Choux
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D001932:Brain Neoplasms / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000534:rehabilitation*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D008297:Male