A multicomponent behavioral program for oral aversion in children dependent on gastrostomy Feedings

Objectives: Describe outcomes in nine children with Nissen fundoplication and feeding gastrostomy treated in a multicomponent feeding program. The importance of comprehensive evaluation, appetite regulation, and family-focused intervention within a behavioral feeding program are discussed. Methods: Prospective clinical intervention with dependent measures evaluated before treatment, after treatment, and at follow-up. Results: Nine children (4 girls; mean age, 3.1 +/- 1.2 years; range, 1.8-5.5 years) and their mothers were admitted for intensive treatment (mean duration, 11.4 +/- 1.7 days; range, 5-16 days). At discharge, 4 of 9 (44%) children were weaned completely from gastrostomy feedings. The mean oral intake of all patients increased 50% from pretreatment to posttreatment assessment. At a mean of 3.1 +/- 0.5 months (range, 2.4-3.6 months) after treatment, six of nine children were weaned completely from gastrostomy feedings. The percent of daily nutritional needs consumed orally increased from a pretreatment mean of 14.6% +/- 21.2% (range, 0%-67%) to a posttreatment mean of 63.4% +/- 18.3% (range, 34%-85%) and a follow-up mean of 88.1% +/- 25.1% (range, 30%-100%). The mean percent ideal body weight for height was not compromised during intensive treatment. Conclusions: Short-term intensive biobehavioral treatment was successful in improving oral intake and weaning from gastrostomy tube feeding in children with Nissen fundoplication and feeding gastrostomy. (C) 2003 Lippincott Williams Wilkins, Inc.