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Moving From Tube to Oral Feeding in Medically Fragile Nonverbal Toddlers

Davis, Ann McGrath*; Bruce, Amanda Schurle; Mangiaracina, Cathy; Schulz, Trina§; Hyman, Paul

Journal of Pediatric Gastroenterology and Nutrition: August 2009 - Volume 49 - Issue 2 - p 233–236
doi: 10.1097/MPG.0b013e31819b5db9
Original Articles: Hepatology and Nutrition

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:

The authors report no conflicts of interest.

© 2009 Lippincott Williams & Wilkins, Inc.