Intensive multidisciplinary intervention (IMI) can reduce dependence on gastrostomy tube (G-tube) feeding in children with pediatric feeding disorder. However, there are no data on using IMI to prevent G-tube placement in children with nasogastric tubes (NGTs). This study describes outcomes of patients with an NGT in place admitted to IMI with the goal of prevention of G-tube placement. Retrospective data from 2017 to 2022 including demographics, anthropometric data, and energy intake were assessed for children with NGT completing an 8-week IMI (at intake, discharge, and 1-year follow-up). Success was defined as taking 100% energy orally and improving nutrition status or maintaining weight-for-length/body mass index z-score > -2. Thirty patients (11 females) with mean age of 21.8 months (SD: 15.4) and with NGT in place for a mean of 7.1 months (SD: 4.7) and mean oral energy consumption of 18.1% (SD: 20.9) were included. At 1-year follow-up, 23 patients (76%) successfully had their NGT removed and maintained nutrition status. Successful children were likely to be older (average: 24.2 vs 14 months; P = 0.03) and consuming a greater proportion of energy orally at discharge (mean: 88.6% vs 42.0%; P = 0.001). No differences were seen between the groups in anthropometric measurements, length of NGT placement, or percentage of energy consumed orally at admission. IMI is a potentially useful tool to help increase oral intake and prevent the need for G-tube placement. Future research is needed to demonstrate who benefits the most from this type of approach and to understand the ideal treatment methodology to optimize outcomes.
Dempster et al. (Fri,) studied this question.