The current article describes a 14-week outpatient protocol for transitioning from gastrostomy tube to oral feeding in toddlers with medical complications. The team ensured that eating skills were mastered before treating patients for 8 weeks with continuous gastrojejunal drip tube feedings and low-dose tricyclic antidepressant and/or gabapentin. We prescribed 6 weeks of megestrol for hunger provocation while withdrawing tube feedings. A chart review after treatment demonstrated 9 subjects were eating exclusively orally and 1 was eating 50% orally.
*Department of Pediatrics, USA
†Hoglund Brain Imaging Center, USA
‡Center for Child Health and Development, University of Kansas Medical Center, Kansas City, USA
§Department of Occupational Therapy, University of Kansas Hospital, Kansas City, KS, USA
¶Department of Pediatrics, Children's Hospital of New Orleans, New Orleans, LA, USA
Received 23 September, 2008
Accepted 7 January, 2009
Address correspondence and reprint requests to Ann McGrath Davis, University of Kansas Medical Center, Mail Stop 4004, 3901 Rainbow Boulevard, Kansas City, KS 66160-7330 (e-mail: firstname.lastname@example.org).
The authors report no conflicts of interest.