Successful Gastrostomy Tube Weaning Program Using an Intensive Multidisciplinary Team Approach

Objectives:The present study evaluated the effectiveness of a multidisciplinary intensive inpatient model for gastrostomy tube (GT) weaning.Methods:A retrospective chart review was completed on 30 GT-dependent children, ages 3.9 (1.4) years, admitted to the inpatient feeding program (length of stay 19 days) from May 2009 to December 2011. Administered GT calories were decreased on admission by an average of 73% from home regimen. Patients were offered 3 meals and 2 to 3 snacks/day, including 3 intensive feeding therapy sessions (Monday to Friday), along with psychosocial support, nutrition guidance, and behavioral therapy. Daily calorie counts and weights were recorded. Patients returned for a postdischarge feeding evaluation at an average of 4 months and a clinic visit at 1 year. Data were analyzed using paired samples t tests.Results:Before admission, patients received 69% (+/- 25) of goal calories by GT and 22% (+/- 19) of goal calories orally. During admission, average caloric intake by mouth as a percentage of goal increased during the course of weeks 1, 2, and 3 (68%, 77%, and 82%, respectively), with a statistically significant increase between weeks 1 and 2 (P=0.001) and 1 and 3 (P=0.011). At discharge, 90% had discontinued GT feedings. Average percent weight change during admission was 0.2% (+/- 4). At 1 year follow-up, 83% remained successfully off GT feedings.Conclusions:Children who are GT dependent can be weaned off GT feedings during a 3-week admission using a multidisciplinary feeding model. The therapeutic gains were maintained at 1 year postdischarge.