What is tube weaning?
To understand tube weaning one must be aware of what is tube feeding.
Tube feeding: Tube feeding is a process wherein children/infants who possess difficulty in feeding or swallowing orally are fed through a tube to maintain their nutrition and many other reasons. There are different types of feeding tubes used for different reasons, some are temporary, and some are permanent, most common are
1. Nasal tube (nose and generally for the short term)
2. PEG tube (percutaneous endoscopic gastrostomy) (through the stomach and mostly for the long term)
Once the child is ready to eat sufficiently by mouth, (Motor readiness and medical stability are important factors in considering the timing of the transition to oral feedings) tube weaning process is started. This process of transition of feeding from tube to oral feed(feeding through the mouth) is referred to as TUBE WEANING.
There are important factors to be considered before tube waning
1. Medical Stability
2. Muscle strengthening
3. Safe swallowing (No aspiration or penetration of food or liquids to avoid the risk of aspirated pneumonia)
Weaning from feeding tubes can occur in different ways:
Child-Led Or Gradual Weaning – the majority of children who wean off feeding tubes do so gradually over months or years, on their own schedules. Most receive feeding therapy but do not require intensive weaning programs.
Physician Or Therapist-Led Weaning Schedule – when a child is medically ready, his physician or therapist may develop a weaning protocol for reducing and eventually eliminating tube feedings. This type of weaning usually takes weeks to months.
Intensive Feeding Programs – majorly children with behavioral challenges or extreme oral aversions, require an intensive feeding program for weaning. These programs typically take place over a few weeks, with ongoing follow-up care.
Role Of Feeding/Swallowing Therapist In Tube Weaning
Many people often question how feeding therapists can possibly help a child with a tube-wean! Feeding therapists are experts on the movements of the mouth and throat, and all these movements are required to successfully work in order to have effective eating, drinking, and swallowing. In many cases, speech and language therapists undertake specialist training to assist and help a child’s eating, drinking, and swallowing and are referred to as Feeding or Swallowing therapists or Deglutionist.
During the tube-weaning process therapist create the most positive experience with food for a child that a child can link to their mouth, food and drink.
Feeding therapists usually create lots of fun games and activities like food play, food picnic, etc for the child to take part in with food. This
will teach the child to touch, smell and play with their food which indirectly helps a child visually and olfactory accept food. They would conduct messy play with food items which will help a child in accepting food through tactile mode. This will help children to associate food with comfort and use them to deal with the natural instinct of hunger.
A feeding therapist many a time works with different tools such as chewy tubes, jaw biters, oral swabs, z-vibes, different types of cups, and straws. This will strengthen the oral musculature which will help the child to chew and masticate his food and swallow well, which will give a positive approach to a child towards food and liquids.
A tube-weaning program led by a Feeding therapist has many benefits for your child, including:
• Develop safe and effective feeding skills by necessary postural changes and appropriate swallow study.
• Helping children to understand the importance of food in relation to hunger.
• Develops a healthy and positive relationship between the child and food.
• Overcome food aversions and reduce gagging.
• Promote weight gain by increasing oral diet with different tastes and textures food.
• Provide support and reduce anxiety for both child and their family.
