Nutritional adequacy and diet diversity following a tube weaning program

OBJECTIVES: Limited research has examined nutritional changes following tube weaning. The main objective of this study was to investigate the adequacy and quality of nutrition, growth, and gastrointestinal symptoms in children undergoing a 3-week outpatient tube weaning program based on hunger provocation. METHODS: Patient records from all children treated with a tube weaning program at Helsinki University Children's Hospital between May 2016 and May 2024 were reviewed retrospectively for nutritional intake, gastrointestinal symptoms, and growth. RESULTS: The study included 51 patients (median age: 2.7 years interquartile range, IQR 2.1-4.2). Median duration of tube feeding before program was 2.4 years (IQR 1.9-3.3). In the last available follow-up, 37/51 (72.5%) of the children were successfully weaned off tube feeding. After the program, the median proportion of total energy intake derived from regular food and drinks increased from 6.2% to 77.2%, and the median energy derived from tube feeding decreased from 92.9% to 0.0% (p < 0.05 for all). Dietary diversity increased during follow-up, and a decrease in gastrointestinal symptoms was observed. After weaning, the intake of several vitamins and minerals from regular food alone did not meet the recommended levels and required supplementation. CONCLUSIONS: Our tube weaning program was effective in decreasing tube dependency, improving oral intake, and increasing dietary diversity. To ensure adequate energy, vitamin, and mineral intake, a sufficiently long-term follow-up after weaning and appropriate dietary supplementation are essential to prevent potential deficiencies. Securing growth and nutritional status requires a regular evaluation of dietary adequacy by a nutrition specialist.