Rapid Outpatient Tube Weaning Is Effective but Associated With Frequent Adverse Events: A Retrospective Cohort Study.

AIM: To evaluate the outcomes and safety of an outpatient tube-weaning programme involving rapid tube feed reduction.

METHODS

This retrospective patient record-based cohort study included children referred to a multidisciplinary, hunger provocation-based tube-weaning programme from 2016 to 2023 in our tertiary paediatric hospital. The primary outcome was complete tube weaning. Secondary outcomes were changes in oral feeding skills and adverse effects.

RESULTS

We traced 49 children with mostly somatic underlying diseases who had taken part in the programme. Of them, 65% achieved complete weaning and oral feeding improved in 92%, by programme completion. At a median follow-up of 2.4 years, 69% remained fully weaned. Patients with neurodevelopmental diseases benefited least. Adverse effects occurred in 49%, most commonly hypoglycaemia (37%) and dehydration (31%). Lower initial oral feeding skill was associated with reduced weaning success and a higher incidence of hypoglycaemic events. Children experiencing adverse effects-particularly hypoglycaemia-were less likely to be fully weaned.

CONCLUSIONS

Rapid tube feed reduction within an outpatient hunger-provocation programme improved oral feeding but was associated with notable adverse effects. These findings support individualized tube feed reduction, patient monitoring and careful patient selection.