A Multicomponent Behavioral Program for Oral Aversion in Children Dependent on Gastrostomy Feedings

Abstract

ABSTRACT Objectives Describe outcomes in nine children with Nissen fundoplication and feeding gastrostomy treated in a multicomponent feeding program. The importance of comprehensive evaluation, appetite regulation, and family‐focused intervention within a behavioral feeding program are discussed. Methods Prospective clinical intervention with dependent measures evaluated before treatment, after treatment, and at follow‐up. Results Nine children (4 girls; mean age, 3.1 ± 1.2 years; range, 1.8–5.5 years) and their mothers were admitted for intensive treatment (mean duration, 11.4 ± 1.7 days; range, 5–16 days). At discharge, 4 of 9 (44%) children were weaned completely from gastrostomy feedings. The mean oral intake of all patients increased 50% from pretreatment to posttreatment assessment. At a mean of 3.1 ± 0.5 months (range, 2.4–3.6 months) after treatment, six of nine children were weaned completely from gastrostomy feedings. The percent of daily nutritional needs consumed orally increased from a pretreatment mean of 14.6% ± 21.2% (range, 0%–67%) to a posttreatment mean of 63.4% ± 18.3% (range, 34%–85%) and a follow‐up mean of 88.1% ± 25.1% (range, 30%–100%). The mean percent ideal body weight for height was not compromised during intensive treatment. Conclusions Short‐term intensive biobehavioral treatment was successful in improving oral intake and weaning from gastrostomy tube feeding in children with Nissen fundoplication and feeding gastrostomy.