Parent-Mediated Responsive Feeding Therapy for Tube Weaning in Children with Neurodevelopmental Conditions: A Comparative Case Series

AIMS: To compare outcomes of parent-mediated Responsive Feeding Therapy (RFT) in three young children with neurodevelopmental conditions and longstanding gastrostomy tube (G-tube) dependence. METHODS: in-person, virtual, or hybrid modalities, and a follow-up phase consisting of virtual coaching (average 17 sessions). Outcomes included tube dependence, feeding behaviors, oral-motor skills, and parental stress. RESULTS: Two children with neuromotor conditions achieved complete tube weaning by three months. One child with a growth disorder reduced tube dependence to 50% while acquiring feeding skills. All children achieved significant oral-motor and behavioral improvements. Parent stress scores were elevated and increased across all cases. CONCLUSIONS: RFT demonstrates promise for tube-dependent children with neurodevelopmental conditions. Complete weaning was achieved in children with neuromotor disorders through in-person and hybrid delivery, while virtual delivery for a child with a growth disorder resulted in partial weaning. Universal improvements in feeding behaviors were observed; elevated parental stress likely reflects increased responsibility inherent to parent-mediated feeding interventions.