Acceptability and Feasibility of Rapid Tube Weaning During Intensive Multidisciplinary Feeding Intervention.

Objective: The primary objective of this pilot trial was to determine to what extent hunger provocation, via rapid weaning from enteral feedings, was acceptable and feasible and to evaluate the effect of this intervention when used during intensive multidisciplinary feeding intervention for children dependent on enteral feedings.

Method: The study was conducted at an Intensive Multidisciplinary Program located in the Southeastern United States from May 2021 to October 2023. Children were randomly assigned 1:1 to standard wean or rapid wean using permuted blocks of 2 and 4 with allocation pattern concealed to investigators resulting in respective cohort sizes of 8 (N = 16 participants, total) for 8 weeks. Feasibility benchmarks and data completeness were summarized using percentages and means. The study also evaluated the effect of intervention on treatment outcomes including weight-for-age z-score, percentage of daily caloric needs met by mouth, percent of patients achieving ≥1 day where 100% of caloric needs were met via oral feeding, and time to effect.

Results: Feasibility and acceptability benchmarks were achieved. Preliminary outcome data suggest rapid tube weaning did not influence reaching 100% oral intake or fully weaning from a feeding tube when used as an adjunct to behavioral intervention.

Conclusion: This study was a prerequisite to support a future efficacy randomized clinical trial to further study how to optimize outcomes to achieve full weaning from tube feeding.