Weaning From a Tube Feeding
When a child is put on a feeding tube often the first question a parent wants answered is when they will be able to come off of the tube. This can be a very complicated question and really depends on a myriad of factors. Some of the issues that have to be considered in order to safely wean a child from a tube feeding will be discussed in this article but please understand that this is not an exhaustive list.
One of the first thing to consider when we talk about weaning from a tube feeding is whether the issue that required tube placement had been resolved. If the original issue is still outstanding then removal of the tube may only be temporary and the tube may have to be replaced as soon as the nutritional status again plummets. Making sure that the problem that was addressed by the tube is resolved can help prevent this from happening.
The oral status of the child must be addressed as well. If the child is still having issues with swallowing that may prevent weaning then it may not be time. Aversions also have to be addressed as well as the willingness of the child to feed orally. All of these issues have to fall into place in order to successfully wean the child from the feeding tube.
Introducing oral feedings to a child who has been exclusively tube fed should be done slowly and with a lot of patience from the parents or caregiver. This can be a very slow process with somewhat of a "three steps forward and two steps back" kind of deal. A child may only start with very few drops of food or liquid given orally until they are able to tolerate larger feedings. A child with a history of aspirations may need to be monitored during feedings.
Sometimes the physician may recommend decreasing the tube feedings in order to allow the child to become hungry. Hunger is an important motivator for oral feedings. It is usually best to offer the oral feedings before filling the child's belly through the tube. Otherwise you may be fighting a loosing battle.
Allowing a child to play with the food or utensils as is age appropriate can help with their willingness to feed. Self-feeding for older children can also help the child become more interested in feedings. Discuss all of these options with your child's doctor.
Patience will pay off! Hopefully your child will begin to eat more and more until the tube feedings are no longer needed. Most of the children that I have worked with who are placed on tube feedings to deal with acid reflux do end up weaning from those feedings. If your child has other issues on top of acid reflux their need for and duration of use of a tube feeding will vary.