Among children who are fed through a tube and experience oral feeding difficulties, some may develop a dependence on artificial nutrition and encounter difficulties in being weaned off, even though their health may permit it.
To face this problem, medical teams generally implement outpatient weaning as a first attempt, which involves regular monitoring for a variable amount of time (weaning periods lasting 6 days to 18 months have been reported in the literature), with two main focuses:
- Reducing calories ingested through tube feeding;
- Monitor growth, give support and guide the child and their family.
Ideally, weaning is conducted by a multidisciplinary team including a paediatric gastroenterologist, a psychologist, a dietician and a speech therapist.
In case of failure as an outpatient or if the weaning is prolonged without significant progress, a weaning in hospital as an outpatient or in a long-stay centre may be considered. Weaning is usually considered to be long when it takes more than one year.
Please note however that for some patients, the multidisciplinary team may immediately resort to hospitalised weaning. This is particularly the case in the absence of suitable family or re-educative support for the child.
These types of treatments require great effort from the entire family supported by a medical team, as well as awareness and cohesion of all health professionals involved. These stays are addressed to children for whom a tube feeding weaning project has been accepted by the referring hospital's medical team. The support of the medical team and the family, compliance with contraindications and the evaluation of the child’s oral feeding skills are in fact prerequisites to check before organising a stay for weaning off tube feeding.
For several years now, some Soins de Suite et Réadaptation (SSR, or Follow-up and Re-adaptation Treatment) structures have offered long-term stay possibilities and recently formalised weaning protocols:
- Centre Pédiatrique des Cotes aux Loges in Josas (78)
- Centre André Bousquairol in Toulouse
- Centre Ty Yann in Brest
Their methods may vary: full-time hospitalisation for 4 to 6 weeks with week-end leave, daily outpatient visits for 2 weeks or outpatient visits 1 day a week.
Other structures ensuring weaning stays are being created in France, and two of them are located in the Hauts-de-France region:
- SSR Pédiatrique Marc Sautelet in Villeneuve-d'Ascq (59) -For more information, contact the outpatient care manager at 03 28 80 07 70
- SSR L’ADAPT in Cambrai (59)
You can contact firstname.lastname@example.org for more information.