Moving from tube to oral feeding in medically fragile nonverbal toddlers.
The current article describes a 14-week outpatient protocol for transitioning from gastrostomy tube to oral feeding in toddlers with medical complications. The team ensured that eating skills were mastered before treating patients for 8 weeks with continuous gastrojejunal drip tube feedings and low-dose tricyclic antidepressant and/or gabapentin. We prescribed 6 weeks of megestrol for hunger provocation while withdrawing tube feedings. A chart review after treatment demonstrated 9 subjects were eating exclusively orally and 1 was eating 50% orally.
Davis
Ann McGrath
AM
Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS 66160-7330, USA. adavis6@kumc.edu
Bruce
Amanda Schurle
AS
Mangiaracina
Cathy
C
Schulz
Trina
T
Hyman
Paul
P
D000588:Amines / Q000627:therapeutic use*; D000700:Analgesics / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D001069:Appetite Regulation; D019167:Appetite Stimulants / Q000627:therapeutic use; D002652:Child Behavior / Q000523:psychology; D002657:Child Development; D002675:Child, Preschool; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D004435:Eating / Q000523:psychology; D004750:Enteral Nutrition / Q000379:methods*; D005247:Feeding Behavior / Q000523:psychology; D019959:Feeding and Eating Disorders of Childhood / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D000077206:Gabapentin; D005774:Gastrostomy / Q000379:methods; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000523:psychology; D008297:Male; D008535:Megestrol / Q000627:therapeutic use; D009048:Motor Skills; D010146:Pain / Q000188:drug therapy* / Q000523:psychology; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
D000588:Amines; D000700:Analgesics; D000929:Antidepressive Agents, Tricyclic; D019167:Appetite Stimulants; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D008535:Megestrol