Evaluation of an intensive desensitisation, oral tolerance therapy and hunger provocation program for children who have had prolonged periods of tube feeds.
Int J Evid Based Healthc
; 8(4): 268-76, 2010 Dec.
Article
in En
| MEDLINE
| ID: mdl-21091893
ABSTRACT
BACKGROUND:
Some children with feeding difficulties may require nasogastric tube feeding or insertion of a percutaneous endoscopic gastrostomy (PEG) from a young age. A small cohort of these children can develop severe oral aversions that can delay the re-introduction of oral feeding. Multidisciplinary approaches that provide an intensive approach are deemed the most effective method of intervention to reduce nasogastric and PEG dependency.METHODS:
Two children and their parents received an intensive approach to reduce PEG feeds (Child A and Child B), while one child and her parents elected to receive a traditional feeding clinic approach (Child C). The mean age of the participants was 4 years 4 months.RESULTS:
Child A initially took 2090 kJ (44% daily nutritional requirement) via her PEG before the intensive program, and Child B took 100% daily nutritional requirement via his PEG. Three months post the intervention, Child A took 100% of her nutritional requirements orally and Child B had reduced PEG requirement significantly to 38% of daily nutritional requirement. Child C showed no changes in PEG versus oral intake. Children who received the intervention were able to remain focused on mealtimes for longer, with fewer instances of leaving the table. Parents altered their language styles post coaching on the intensive intervention using fewer reprimands. No changes with these behaviours were noted with Child C.CONCLUSIONS:
Although this was a small pilot study, there are some strategies used within an intensive multidisciplinary context that can enable children to reduce their reliance on PEG feeds significantly.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Gastrostomy
/
Child Behavior
/
Enteral Nutrition
/
Feeding and Eating Disorders of Childhood
/
Eating
/
Feeding Behavior
Type of study:
Etiology_studies
/
Evaluation_studies
/
Prognostic_studies
Aspects:
Determinantes_sociais_saude
Limits:
Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
Int J Evid Based Healthc
Journal subject:
SERVICOS DE SAUDE
Year:
2010
Document type:
Article
Affiliation country:
United kingdom