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Weight loss during ambulatory tube weaning: don’t put the feeds back up
  1. Charlotte Margaret Wright1,
  2. Stephanie McNair1,
  3. Beatrice Milligan1,
  4. Jennifer Livingstone2,
  5. Emily Fraser2
  1. 1Department of Child Health, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
  2. 2Dietetics Department, Royal Hospital for Children, NHS Greater Glasgow and Clyde, Glasgow, UK
  1. Correspondence to Professor Charlotte Margaret Wright, Department of Child Health, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK; charlotte.wright{at}glasgow.ac.uk

Abstract

Objective To describe the prevalence of weight loss during tube weaning and its impact on wean duration and growth.

Setting Tertiary feeding clinic, UK.

Patients All children seen for weaning from long-term enteral feeding between 2008 and 2016.

Interventions Outpatient withdrawal of enteral feeding.

Design Case series of children being weaned from tube feeding, documenting clinical details, periods of weight loss and timing of feed changes, as well as height and weight at baseline and within 1 year after feed cessation.

Main outcome measures Amount and frequency of weight loss, wean duration, change in body mass index (BMI) and height SD z score.

Results Weaning was attempted in 58 children, median age 2.7 years, and 90% had stopped feeds after median (range) 5.9 (1–40) months. Weight loss was seen in 51 (88%) children and was more common and severe in children with initially higher BMI. Time to feed cessation reduced by median 4.9 months between 2008–2011 and 2012–2016, while having feeds increased prolonged the wean duration, by median 13 months. After feed cessation, mean (95% CI) BMI had dropped by 0.84 (0.5 to 1.2) z scores, but neither change in BMI, nor the amount and frequency of weight loss, related to growth.

Conclusions Short-term weight loss is to be expected during tube weaning and is not associated with compromised growth. It is important to avoid overfeeding enterally fed children and not to increase feeds again in response to weight loss.

  • Growth
  • Gastroenterology
  • Paediatrics

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Footnotes

  • Contributors CMW—conceptualisation, data curation, project administration, formal analysis, methodology, writing original draft, review, editing and guarantor. EF and JL—conceptualisation, review and editing. SM and BM—project administration, data curation, review and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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