Feeding Disorders in Children With Tracheostomy Tubes. Nutr Clin Pract 2021 Jun;36(3):689-695
Date
07/24/2020Pubmed ID
32700397DOI
10.1002/ncp.10551Scopus ID
2-s2.0-85088361351 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
BACKGROUND: We aimed to describe feeding dysfunction in a group of children with tracheostomy.
METHODS: Single-center, retrospective chart review of all children with a tracheostomy who were evaluated by our interdisciplinary feeding program. Demographic and diagnostic data, nutrition variables, acceptance of food consistencies, as well as 2 validated psychometric instruments for assessment of feeding dysfunction were analyzed.
RESULTS: Thirteen tracheostomy-dependent children (5/13; 38% ventilator dependent) were evaluated at a median age of 51 months (interquartile range [IQR], 26-69). The majority of children (8/13; 62%) underwent evaluation after decannulation. Four children (30%) had a history of a cuffed tracheostomy tube. Eleven children (85%) used a speaking valve prior to decannulation, only 2 of whom started before initial discharge with a tracheostomy. Children with a tracheostomy had low-median weight- and height-for-age z-scores (-1.27 and -1.73, respectively), with normal-median body mass index (BMI)-for-age z-score (0.175). Children received 75% of feedings via tube feeding (IQR, 13%-97%). Compared with other children with feeding disorders, children with tracheostomy had delays in initial acceptance of most food textures and general diet, and the Mealtime Behavior Questionnaire showed significantly worse overall scores (P = .01), and the About Your Child's Eating survey showed significantly higher parental perception of resistance to eating (P = .0001).
CONCLUSION: Requirement of enteral nutrition, poor oral-feeding skills, chronic malnutrition, and worse mealtime behaviors are associated with tracheostomy. A history of ventilator dependence, cuffed tracheostomy, and inpatient speaking valve-use were infrequently associated with interdisciplinary feeding-program evaluation.
Author List
Henningfeld J, Lang C, Erato G, Silverman AH, Goday PSAuthors
Jennifer Henningfeld MD Associate Professor in the Pediatrics department at Medical College of WisconsinAlan Silverman PhD Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
ChildChild, Preschool
Enteral Nutrition
Feeding Behavior
Feeding and Eating Disorders
Humans
Nutritional Status
Retrospective Studies
Tracheostomy
