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Helping children stop or avoid enteral feeding

Long term enteral feeding is widely used to provides vital support for infants and children unable to feed orally, but once medically stable the transition to a normal diet can be difficult. Other children may need to commence tube feeding later in childhood because of difficulties associated with n...

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Detalles Bibliográficos
Autor principal: Wright, Charlotte
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4652724/
https://www.ncbi.nlm.nih.gov/pubmed/26734193
http://dx.doi.org/10.1136/bmjquality.u201097.w702
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author_facet Wright, Charlotte
author_sort Wright, Charlotte
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description Long term enteral feeding is widely used to provides vital support for infants and children unable to feed orally, but once medically stable the transition to a normal diet can be difficult. Other children may need to commence tube feeding later in childhood because of difficulties associated with neurodisability, but recognising which children will benefit from tube feed is not straightforward. The Royal Hospital for Sick Children, Yorkhill set up a multidisciplinary feeding team in 2002 to help avoid unnecessary tube feeding. We accept only children who are either artificially fed or with severe nutritional problems and only after attempted uni-disciplinary management. The team members are a clinical psychologist, paediatric dietitian and consultant paediatrician, supported by a specialist paediatric registrar, assistant psychologist and administrative support. We can see only a small proportion of all with complex feeding problems, but aim to improve the care of such children generally. We disseminate the lessons learned within the Feeding Clinic via education locally and nationally and have an active programme of research. Over the first ten years of the clinic we have seen 222 patients of whom 67% were initially either tube or oral supplement fed, while only 29% remain so at follow up. In the first three years of the clinic tube fed children had spent a median of seven years on feeds before they were successfully weaned, but since then that has fallen to a median of 2.7 years. Of 53 other children referred for possibly tube feeding, 32 (60%) remain well on a normal diet and only ten (19%) have needed to start tube feeding. The service is highly cost effective. Salary costs are only around £65,000 per year, while weaning five children per year, reducing their years on feeds by four years, saves the NHS £130,000.
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spelling pubmed-46527242016-01-05 Helping children stop or avoid enteral feeding Wright, Charlotte BMJ Qual Improv Rep BMJ Quality Improvement Programme Long term enteral feeding is widely used to provides vital support for infants and children unable to feed orally, but once medically stable the transition to a normal diet can be difficult. Other children may need to commence tube feeding later in childhood because of difficulties associated with neurodisability, but recognising which children will benefit from tube feed is not straightforward. The Royal Hospital for Sick Children, Yorkhill set up a multidisciplinary feeding team in 2002 to help avoid unnecessary tube feeding. We accept only children who are either artificially fed or with severe nutritional problems and only after attempted uni-disciplinary management. The team members are a clinical psychologist, paediatric dietitian and consultant paediatrician, supported by a specialist paediatric registrar, assistant psychologist and administrative support. We can see only a small proportion of all with complex feeding problems, but aim to improve the care of such children generally. We disseminate the lessons learned within the Feeding Clinic via education locally and nationally and have an active programme of research. Over the first ten years of the clinic we have seen 222 patients of whom 67% were initially either tube or oral supplement fed, while only 29% remain so at follow up. In the first three years of the clinic tube fed children had spent a median of seven years on feeds before they were successfully weaned, but since then that has fallen to a median of 2.7 years. Of 53 other children referred for possibly tube feeding, 32 (60%) remain well on a normal diet and only ten (19%) have needed to start tube feeding. The service is highly cost effective. Salary costs are only around £65,000 per year, while weaning five children per year, reducing their years on feeds by four years, saves the NHS £130,000. British Publishing Group 2013-09-20 /pmc/articles/PMC4652724/ /pubmed/26734193 http://dx.doi.org/10.1136/bmjquality.u201097.w702 Text en © 2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ http://creativecommons.org/licenses/by-nc/2.0/legalcode
spellingShingle BMJ Quality Improvement Programme
Wright, Charlotte
Helping children stop or avoid enteral feeding
title Helping children stop or avoid enteral feeding
title_full Helping children stop or avoid enteral feeding
title_fullStr Helping children stop or avoid enteral feeding
title_full_unstemmed Helping children stop or avoid enteral feeding
title_short Helping children stop or avoid enteral feeding
title_sort helping children stop or avoid enteral feeding
topic BMJ Quality Improvement Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4652724/
https://www.ncbi.nlm.nih.gov/pubmed/26734193
http://dx.doi.org/10.1136/bmjquality.u201097.w702
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