Gastrostomy (G-) and gastro-jejunal (G-J) feeding tubes are placed in infants and children who refuse to eat or are unable to eat enough to sustain normal growth due to a variety of medical reasons: neurological disease, heart defects, and genetic disorders, among others. Although often intended as temporary, short-term solution to medical complications, feeding tubes can become a permanent conduit for enteral nutrition. While tube feeding routinely saves the lives of children who exhibit chronic oral food refusal, long-term continuation of tube feeding creates a significant financial, psychological, and emotional burden to patients, caregivers, and families. Making the transition to oral feeding is crucial for children to achieve their full potential for a healthy and productive life. The purpose of this application is to investigate the effectiveness of a 24-week outpatient multidisciplinary treatment using amitriptyline to treat pain in young children in order to transition from gastrostomy feeding to oral feeding.

Public Health Relevance

Improved preterm infant survival has increased the prevalence of feeding problems in older infants and toddlers and severe feeding problems occur in over half of children with chronic medical conditions. As the prevalence of gastrostomy tube feeding has increased, so have the challenges associated with transitioning a child from tube to oral feeding. Achieving the transition from tube to oral feeding is critical for children to reach their full potential of a healthy and productive life.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21HD066629-02
Application #
8119665
Study Section
Nursing Science: Children and Families Study Section (NSCF)
Program Officer
Zajicek, Anne
Project Start
2010-08-01
Project End
2014-07-31
Budget Start
2011-08-01
Budget End
2014-07-31
Support Year
2
Fiscal Year
2011
Total Cost
$218,157
Indirect Cost
Name
University of Kansas
Department
Pediatrics
Type
Schools of Medicine
DUNS #
016060860
City
Kansas City
State
KS
Country
United States
Zip Code
66160
Davis, Ann M; Dean, Kelsey; Mousa, Hayat et al. (2016) A Randomized Controlled Trial of an Outpatient Protocol for Transitioning Children from Tube to Oral Feeding: No Need for Amitriptyline. J Pediatr 172:136-141.e2
Davis, Ann M; Bruce, Amanda S; Khasawneh, Rima et al. (2013) Sensory processing issues in young children presenting to an outpatient feeding clinic. J Pediatr Gastroenterol Nutr 56:156-60