Tube-weaning infants and children: a survey of Australian and international practice

Aim: The aim of this study was to describe paediatric feeding-tube weaning practice in Australian children's hospitals and to compare this with practice in tube weaning programmes internationally.

Methods: A literature review regarding tube weaning practices was conducted to inform questionnaire design. Six Australian children's hospitals and six international paediatric service providers completed a written questionnaire.

Results: Four of six Australian children's hospitals surveyed reported that they have adopted informal paediatric tube weaning practices; four of six lacked clinical practice guidelines (CPGs), and five of six lacked a clearly defined case leadership. Practice varied substantially within and between these Australian feeding teams. By comparison, all six international feeding teams reported having developed formal CPGs. Five of six reported clearly defined case leadership with no more than three lead professionals overseeing cases and concordantly reported a high level of practice consistency within and between teams.

Conclusions: The majority of Australian children's hospitals lack a formal CPG and clearly defined case leadership to guide tube weaning practices, and accordingly, there is considerable practice variation. This is in contrast to the situation in a select group of international centres. There is a need for further research to define best practice models and for Australian CPGs.