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Weaning children from prolonged enteral nutrition: A position paper

European Journal of Clinical Nutrition volume 76, pages 505–515 (2022)Cite this article

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Abstract

Enteral nutrition (EN) allows adequate nutritional intake in children for whom oral intake is impossible, insufficient or unsafe. With maturation and health improvements, most children ameliorate oral skills and become able to eat orally, therefore weaning from EN becomes a therapeutic goal. No recommendations currently exist on tube weaning, and practices vary widely between centres. With this report, the French Network of Rare Digestive Diseases (FIMATHO) and the French-Speaking Group of Paediatric Hepatology, Gastroenterology and Nutrition (GFHGNP) aim to develop uniform clinical practice recommendations for weaning children from EN. A multidisciplinary working group (WG) encompassing paediatricians, paediatric gastroenterologists, speech–language therapists, psychologists, dietitians and occupational therapists, was formed in June 2018. A systematic literature search was performed on those published from January 1, 1998, to April 30, 2020, using MEDLINE. After several rounds of e-discussions, relevant items for paediatric tube weaning were identified, and recommendations were developed, discussed and finalized. The WG members voted on each recommendation using a nominal voting technique. Expert opinion was applied to support the recommendations where no high-quality studies were available.

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Fig. 1: Weaning enteral nutrition in tube-dependent children: management flowchart.

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  • 11 October 2021

    The name Gaelle Malécot-Le Meur has been tagged correctly.

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Acknowledgements

We thank Helen Cléry from the French Network of Rare Digestive Diseases (FIMATHO) for her unvaluable help in managing the project. French Network of Rare Digestive Diseases (FIMATHO).

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Author notes

  1. These authors contributed equally: Haude Clouzeau, Valeria Dipasquale.

Authors and Affiliations

  1. Hôpital des Enfants, CHU de Bordeaux, Bordeaux, France

    Haude Clouzeau

  2. Univ. Lille, CHU Lille, U1286 INFINITE, F-59000 Lille, France, Filière FIMATHO, CRACMO, MaRDI, Lille, France

    Valeria Dipasquale, Katia Lecoeur, Audrey Lecoufle, Dominique Guimber, Audrey Van Malleghem & Frédéric Gottrand

  3. Centre Pédiatrique des Cotes, Les loges en Josas, Les Loges-en-Josas, France

    Laila Rivard

  4. SSR Pédiatrique de Ty Yann, fondation Ildys, Brest, France

    Valérie Le Ru-Raguénès & Mélanie Bué-Chevalier

  5. CHU Robert Debré Paris (MaRDI), Bd Sérurier, Paris, France

    Véronique Leblanc & Marc Bellaïche

  6. CHU Necker CRMR SPRATON, Paris, France

    Gaelle Malécot-Le Meur & Véronique Abadie

  7. Centre André Bousquairol, Toulouse, France

    Sophie Baeckeroot, Aline Genevois-Peres & Sophie Dubedout

  8. CHU Lyon (MaRDI), Lyon, France

    Irène Loras-Duclaux

  9. CHU Grenoble, Grenoble, France

    Amandine Rubio

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Contributions

H.C., L.R., K.L., A.L., V.L.R.-R., D.G., V.L., G.M.-L.M., S.B., A.V.M., I.L.-D., A.R., A.G.-P., S.D., M.B.-C., M.B., V.A. and F.G. designed research; L.R., K.L., A.L., V.L.R.-R., D.G., V.L., G.M., S.B., A.V.M., I.L.-D., A.R., A.G.-P., S.D., M.B.-C., M.B. and V.A. conducted research; H.C., V.D. and F.G. analyzed data; and V.D. wrote the paper. H.C., V.D. and F.G. had primary responsibility for final content. All authors read and approved the final manuscript.

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Correspondence to Valeria Dipasquale.

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Clouzeau, H., Dipasquale, V., Rivard, L. et al. Weaning children from prolonged enteral nutrition: A position paper. Eur J Clin Nutr 76, 505–515 (2022). https://doi.org/10.1038/s41430-021-00992-5

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