Rapid Outpatient Tube Weaning Is Effective but Associated With Frequent Adverse Events: A Retrospective Cohort Study

AIM: To evaluate the outcomes and safety of an outpatient tube-weaning programme involving rapid tube feed reduction. METHODS: This retrospective patient record-based cohort study included children referred to a multidisciplinary, hunger provocation-based tube-weaning programme from 2016 to 2023 in our tertiary paediatric hospital. The primary outcome was complete tube weaning. Secondary outcomes were changes in oral feeding skills and adverse effects. RESULTS: We traced 49 children with mostly somatic underlying diseases who had taken part in the programme. Of them, 65% achieved complete weaning and oral feeding improved in 92%, by programme completion. At a median follow-up of 2.4 years, 69% remained fully weaned. Patients with neurodevelopmental diseases benefited least. Adverse effects occurred in 49%, most commonly hypoglycaemia (37%) and dehydration (31%). Lower initial oral feeding skill was associated with reduced weaning success and a higher incidence of hypoglycaemic events. Children experiencing adverse effects-particularly hypoglycaemia-were less likely to be fully weaned. CONCLUSIONS: Rapid tube feed reduction within an outpatient hunger-provocation programme improved oral feeding but was associated with notable adverse effects. These findings support individualized tube feed reduction, patient monitoring and careful patient selection.