title: Rapid home-based weaning of small children with feeding tube dependency: positive effects on feeding behaviour without deceleration of growth.
abstract: BACKGROUND
  Oral aversion and feeding disorders occur frequently after long-term feeding via a tube. A rapid home-based tube-weaning programme that provides feeding disorder treatment under medical supervision to overcome oral aversion has been developed.
  
  
  OBJECTIVE
  To describe the results of the 4-10-day rapid home-based feeding tube-weaning programme and to determine the prevalence of food aversion and the overall longitudinal effects on feeding behaviour and growth after treatment.
  
  
  METHODS
  The parents of children who participated in the programme between 2005 and 2007 were followed up via questionnaire in 2008. The questionnaire included inquiries about the characteristics of tube feeding, feeding behaviour and growth parameters.
  
  
  RESULTS
  The study group comprised of 18 boys and 21 girls who, at entry, had a median age of 16 months (range, 5-57) and a median duration of tube feeding of 15 months (range, 3-56). The children were followed up for a median of 2 years after treatment (range, 1-3 years). The weaning programme established oral feeding in 89.7% of the children. In all cases where oral feeding was achieved, the feeding behaviour improved after treatment. The growth velocity of all children, as indicated by weight, length and body mass index (BMI), remained constant from the initial evaluation (BMI z-score M=-1.1 ± 1.7) to follow-up (BMI z-score M=-1.2 ± 1.1).
  
  
  CONCLUSIONS
  This rapid weaning programme for children with feeding tube dependency (FTD) improved the feeding behaviour and was associated with constant growth velocity.
authors.affiliation: Institute for Pediatric Feeding Tube Management and Weaning, Siegburg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Wilken
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cremer
authors.forename: Jennifer
authors.initials: J
authors.lastname: Berry
authors.forename: Peter
authors.initials: P
authors.lastname: Bartmann
mesh_terms: D002675:Child, Preschool; D020878:Device Removal / Q000379:methods*; D004750:Enteral Nutrition / Q000295:instrumentation* / Q000379:methods; D005247:Feeding Behavior; D001068:Feeding and Eating Disorders / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006128:Growth; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D008297:Male; D015397:Program Evaluation; D013997:Time Factors; D016896:Treatment Outcome
keywords: Child Psychology; Gastroenterology; Growth; Infant Feeding; Nutrition