Moving from tube to oral feeding in medically fragile nonverbal toddlers

J Pediatr Gastroenterol Nutr. 2009 Aug;49(2):233-6. doi: 10.1097/MPG.0b013e31819b5db9.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Amines / therapeutic use*
  • Analgesics / therapeutic use*
  • Antidepressive Agents, Tricyclic / therapeutic use*
  • Appetite Regulation
  • Appetite Stimulants / therapeutic use
  • Child Behavior / psychology
  • Child Development
  • Child, Preschool
  • Clinical Protocols
  • Critical Care / methods
  • Cyclohexanecarboxylic Acids / therapeutic use*
  • Eating / psychology
  • Enteral Nutrition / methods*
  • Feeding Behavior* / psychology
  • Feeding and Eating Disorders of Childhood / drug therapy*
  • Feeding and Eating Disorders of Childhood / psychology
  • Female
  • Gabapentin
  • Gastrostomy / methods
  • Humans
  • Infant
  • Infant Behavior / psychology
  • Male
  • Megestrol / therapeutic use
  • Motor Skills
  • Pain / drug therapy*
  • Pain / psychology
  • gamma-Aminobutyric Acid / therapeutic use*

Substances

  • Amines
  • Analgesics
  • Antidepressive Agents, Tricyclic
  • Appetite Stimulants
  • Cyclohexanecarboxylic Acids
  • gamma-Aminobutyric Acid
  • Gabapentin
  • Megestrol