Tube dependency

Tube dependency is an unintended result of long-term feeding by enteral nutrition in infants and toddlers.

Affects
Tube dependency can be seen as an iatrogenicfactor which causes physical symptoms, psychological stress and emotional dependency on tube feeding (feeding tube) in absence of any medical indication., it is often not recognized as a diagnosis or complication by medical professionals. There are several types of temporary feeding tubes [(nostril (Nasogastric tube) or directly into the stomach (Gastrostomy) or intestinal (Jejunal tube)] placed, which were intended to last for a short period of a few months which are commonly placed without offering a specific therapeutic support or a specific exit-strategy. Infants and toddlers are not able to make the transition to oral nutrition, as they develop an active aversion to or a disinterest in food.

Tube weaning
Unfortunately, there is only limited literature on the topic of tube weaning. McGrath, Schurle, Bruce, Mangiaracina, Schulz und Hyman assume a pain rehabilitation Kursiver Textapproach. In their study, tube fed children were treated with medication (neuroleptics and analgetics), because the authors were of the opinion that food intake leads to pain in children. In summary the authors examined nine tube fed children between 7 and 52 months. 82% of the sample was successfully weaned. On the contrary, Benoit, Wang und Zlotkin showed a behavioral approach and used methods from behavioral therapy. Benoit et al. successfully weaned 15 (47%) of a total sample of 32 tube fed infants. Another tube weaning approach is called the “graz tube weaning model”.