Intensive Multidisciplinary Intervention for Young Children with Feeding Tube Dependence and Chronic Food Refusal: An Electronic Health Record Review - 22/07/20
, Valerie M. Volkert, PhD 1, 2, Kathryn H. Stubbs, PhD 2, Rashelle C. Berry, MPH, MS, RD 2, Michele Cole Clark, Med, CCC-SLP 2, Erika Lynn Bettermann, MPH 1, Courtney E. McCracken, PhD 1, Carla Luevano, MEd, BCBA 2, Barbara McElhanon, MD 1, 2, Lawrence Scahill, MSN, PhD 1Abstract |
Objective |
To assess characteristics and outcomes of young children receiving intensive multidisciplinary intervention for chronic food refusal and feeding tube dependence.
Study design |
We conducted a retrospective study of consecutive patients (birth to age 21 years) admitted to an intensive multidisciplinary intervention program over a 5-year period (June 2014-June 2019). Inclusion criteria required dependence on enteral feeding, inadequate oral intake, and medical stability to permit tube weaning. Treatment combined behavioral intervention and parent training with nutrition therapy, oral-motor therapy, and medical oversight. Data extraction followed a systematic protocol; outcomes included anthropometric measures, changes in oral intake, and percentage of patients fully weaned from tube feeding.
Results |
Of 229 patients admitted during the 5-year period, 83 met the entry criteria; 81 completed intervention (98%) and provided outcome data (46 males, 35 females; age range, 10-230 months). All patients had complex medical, behavioral, and/or developmental histories with longstanding feeding problems (median duration, 33 months). At discharge, oral intake improved by 70.5%, and 27 patients (33%) completely weaned from tube feeding. Weight gain (mean, 0.39 ± 1 kg) was observed. Treatment gains continued following discharge, with 58 patients (72%) weaned from tube feeding at follow-up.
Conclusions |
Our findings support the effectiveness of our intensive multidisciplinary intervention model in promoting oral intake and reducing dependence on tube feeding in young children with chronic food refusal. Further research on the generalizability of this intensive multidisciplinary intervention approach to other specialized treatment settings and/or feeding/eating disorder subtypes is warranted.
Le texte complet de cet article est disponible en PDF.Keywords : avoidant/restrictive food intake disorder, behavioral intervention, feeding, nutrition, pediatric feeding disorders, tube weaning
Abbreviations : Accept, ARFID, EHR, IMB, MC, RCT
Plan
| The authors declare no conflicts of interest. |
Vol 223
P. 73 - août 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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