Transition from tube feedings to feedings by mouth in children: preventing eating dysfunction.

Tube feeding provides a temporary means of improving nutritional status and growth until a child can be nourished by mouth. Children in transition from tube to oral feeding typically display oral-motor, sensory, and developmental feeding problems and behaviors that make weaning difficult. A smooth transition benefits the child's health immediately by ameliorating eating difficulties and prevents dysfunction later in life. The weaning process from tube to oral feeding is best thought of in developmental terms. A four-step process is suggested to ensure a smooth transition: promote a positive feeding relationship between caregiver and child; determine feeding readiness; normalize feeding, including oral stimulation, eating-related behaviors, environment, and regulation; and initiate a behavioral feeding plan. The awareness and anticipatory guidance of nutrition professionals before this transition maximizes oral-feeding success for the formerly tube-fed child.