Authors (including presenting author) :
Lee LS (1),Lau CL(1),Chau SK(1)(2),Tao QV(2)
Affiliation :
(1)Department of Paediatric and Adolescent Medicine, Queen Mary Hospital (2)Department of Paediatric and Adolescent Medicine, The Duchess of Kent Children's Hospital
Keyword 1: :
Paediatric Feeding Disorders/Dysphagia
Keyword 2: :
Multidisciplinary care/rehabilitation
Keyword 3: :
Tube weaning/dependence
Keyword 4: :
Medical Complexity
Keyword 5: :
Quality of Life
Keyword 6: :
Resource allocation
Introduction :
Children with severe feeding disorders present with heterogeneous aetiologies and complications such as aspiration and malnutrition, often necessitating recurrent hospitalisation and tube feeding. While tube feeding secures nutrition and hydration, prolonged use—especially of nasogastric (NG) tubes—carries medical risks and social burdens. Parents are often highly motivated to attempt oral feeding, at times contrary to medical advice, given that feeding is a paramount component of childhood quality of life. Managing these disorders is a continuous and complex process that demands interdisciplinary coordination. Our multidisciplinary (MDT) feeding team (paediatrics, nursing, speech and occupational therapy, dietetics) guides families in safe oral feeding rehabilitation to ensure a safe transition from tube-dependence to oral feedig.
Objectives :
This study investigates two critical unknowns in paediatric tube weaning: success rates and duration of tube dependence—factors central to service planning and parental decisions about gastrostomy (GT) placement. We aim to (1) determine the proportion of children achieving full oral feeding, (2) characterise nasogastric (NG) tube dependence, (3) identify predictors of successful weaning, and (4) model the time-to-weaning process. The findings will support personalised counselling, realistic expectation-setting, and optimised clinical resource allocation.
Methodology :
We retrospectively reviewed records of children admitted to the Duchess of Kent Children’s Hospital (DKCH) for multidisciplinary feeding services (2016–2025). Inclusion required tube-feeding dependence at referral. The primary outcome was successful weaning (full oral intake without weight loss) at review. Secondary outcomes included median time to weaning and associated factors. A One-Minus Kaplan–Meier curve estimated the probability of achieving full oral feeding, with median time and 95% CI reported. Differences by medical complexity were assessed using the log-rank test.
Result & Outcome :
Safe and sustained transition from tube dependence to oral feeding in 55% of total 124 patients, while achieving measurable improvements in growth and mealtime family function was found in our cohort. The median time to weaning was 4.6 years (95% CI 3.4–5.8). The median service durations required for tube weaning is 4.2~9.5 years for 50~70% of patients. Patients with a multi-system primary disease (n=105, 85%) were statistically less likely (p < 0.001) to achieve full oral feeding than those with a single-system disease. Among those who succeeded, 24 patients (35%) had been on home NG-tube feeding with a median duration of 12.8 months, suggesting a community support programme may be indicated.
