RT Journal Article
SR Electronic
T1 Weight loss during ambulatory tube weaning: don’t put the feeds back up
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 767
OP 771
DO 10.1136/archdischild-2021-323592
VO 107
IS 8
A1 Charlotte Margaret Wright
A1 Stephanie McNair
A1 Beatrice Milligan
A1 Jennifer Livingstone
A1 Emily Fraser
YR 2022
UL http://adc.bmj.com/content/107/8/767.abstract
AB 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.