A multidisciplinary program to wean infants and toddlers from long‐term tube feeding: Lessons learned from a retrospective study

Objectives Children maintain growth and development by ingesting adequate calories and nutrients, typically achieved via oral intake of food and liquids. When unable to eat and drink orally, they need temporary or permanent enteral nutritional support via nasogastric, nasoduodenal, gastrostomy, or jejunostomy tubes. The objectives of this retrospective study are to describe lessons learned from operating a weaning program at ALYN Hospital for over a decade, the characteristics of the patient population (gender, age, medical condition, and type of tube feeding and hospitalization), and which of these characteristics correlate with successful weaning. Methods Data were obtained from the hospital's secure database of 82 infants and toddlers, 37 boys (45.4%) and 45 girls (54.9%) aged 3 months to 10.8 years who took part in a tube feeding intervention from 2011 to 2020. Descriptive and correlational analyses were performed to characterize the participants and their responses to the program. Results Fifty‐one children (62.2%) were less than 2 years, 26 children (31.7%) were 2–4.11 years, and only 5 children were aged 5 years (6.1%) and older. Fifty‐six children were successfully weaned from tube feeding, 9 children were eventually successful, but the process took longer than anticipated, 11 children were partially weaned and 6 were not successfully weaned. Conclusions These results are discussed within the context of a successful weaning program related to participant characteristics (medical condition, age, gender, and weight), and subsequent recommendations are offered related to the intervention setting, duration, and intensity; redefining success in weaning and the need for long‐term follow‐up. What is Known Children whose growth and development are hampered by inability to feed orally need enteral nutritional support by tube feeding. Weaning from tube dependence is a complex process requiring medical, nutritional, behavioral, and functional support. Children who need a comprehensive feeding rehabilitation program often include complex care and multiple‐problem patients. What is New Gender, age, diagnosis, and treatment setting (in‐ or outpatient) do not influence the effectiveness of tube weaning. Medical complexity influences the length but not necessarily the results of the weaning process. The process should be considered successful even if additional nutritional or hydration tube support is provided during periodic medical or metabolic setbacks. Follow‐