Insights into paediatric tube feeding dependency: A speech language pathology perspective

Abstract

Aim: To identify factors that contribute to pediatric tube dependency from the Speech Language Pathology (SLP) perspective. Tube dependency is characterised by the need to remain tube fed after the need for enteral feeding has ended. Most research relates to intervention programmes for tube withdrawal/weaning. However, there is limited research into factors contributing to tube feeding dependency. SLP perspectives about this morbidity have yet to be explored. Method: A sequential mixed methodology was utilised. In the quantitative phase, 43 SLPs completed an online survey. Ten participants were then interviewed for the quantitative phase. Findings from both phases were integrated at the final analysis. Result: There was four clear factors that contributed to tube dependency from the survey; medical condition, the tube fed child’s negative reaction to oral feeding, limited appetite, and insufficient clinical time to transition children to oral feeding. The interview data further explained the survey results. In addition, participants perceived the prolonged use of nasogastric tube (NGT) feeding; parental influence; service delivery issues and the challenges of school transition as contributing factors to tube dependency. Conclusion: SLPs identified that there were often multiple and often competing factors that resulted in tube dependency. Early and ongoing biomedical focus on weight gain continued to affect long-term goals for transitioning to oral feeding. Team goals were not shared or consistent in terms of priorities for the child. This lack of a shared vision led to parents receiving competing and conflicting messages prolonging tube feeding.