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How to select a tube weaning program








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You can’t buy experience; on the contrary, it is priceless. This is the conclusion an Australian study had, which examined tube-weaning programs worldwide.

 

Feeding tubes and the life-sustaining role they play for many children have become a global phenomenon. At the same time parents worldwide are facing the problem that their child needs to be weaned from their feeding tube in due time. There is no shortage of protocols and methods. But which criteria do they follow? And which one is suitable for which child?

A large Australian study recently investigated these questions and compared six Australian tube-weaning programs with six renowned international programs (including NoTube and the  University Children’s Clinic). They considered those variables that may also serve as the deciding factors for parents, when it comes to choosing a program or location. Criteria were: suitability of tube weaning, duration and program-setting, composition and size of the therapeutic were assessed.

Conclusions coming from this evaluation, form a checklist that can be used to evaluate the quality and suitability of a program. The key message is: it’s experience which matters.

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In recommendations the study emphasizes the importance of practice guidelines. These guidelines, a condensation of everything that works well in tube weaning should be developed. If guidelines are missing entirely or are not extensive enough, there might be trying instead of expert treatment. (For example, four out of six institutions in Australia, where tube weaning is a “new” discipline, did not have practice guidelines at the time of the study).

Developed guidelines are made by medical specialists doctors and psychologists who are in charge of the tube weaning programs. The study emphasizes three relevant factors for the efficiency of tube weaning: only few should direct the program, additional training is an advantage and communication in the team should be on a daily basis.

It is an advantage, for various reasons, when only a few lead experts treat the family directly; on one hand, because it gives continuity; ambiguities are more easily avoided and, at the same time, it gives those running the program the chance to gain experience (and to apply it). On the other hand, it allows families to build trust with those caring for their children more rapidly. Especially, when, as the study’s authors note, frequent contact between the responsible doctors and psychologists with the parents is possible and intended it should always be the same person in charge. Daily conversations with psychologically-trained specialists not only answers to questions but this exchange reduces  fear of parents and may play a substantial role in the overall success of the wean.

 

How does NoTube achieve these things? Find out more

 

(Source:): Gardiner A, Fuller D, Vuillermin P. Tube-weaning infants and Children: A survey of Australian and international Practice. Journal of Paedriatics and Child Health, 2014

Christof Huemer

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