Moreno Villares J, Galiano Segovia M J, Marín Ferrer M
Unidad de Nutrición Clínica, Hospital Universitario 12 de Octubre, Madrid, España.
Nutr Hosp. 1998 Mar-Apr;13(2):90-4.
Enteral feedings delivered by either gastrostomy or a nasogastric tube are often used in infants and toddlers to ensure adequate caloric and nutrient intake. If we are not aware of a rapid introduction of oral feedings they may develop poor feeding skills.
Seven infants (mean age: 6.7 months; SD: 3.6) presented this problem during the 1993-96 period. Six of them were using a nasogastric tube, another one a gastrostomy (PEG). At the beginning of the enteral feeding regimen their weight was -3.32 z-score (SD: -1.2) and for height: -2.11 z-score (SD: -0.51). The underlying disease was gastroesophageal reflux (n = 4), esophageal atresia (n = 1), short bowel syndrome (n = 1) and unexplained anorexia (n = 1).
The mean length of artificial nutrition was 20 months (SD: 11.5), although two of the patients still receive nocturnal enteral drip. Six patients resumed a normal feeding pattern within 3 months to 2 years after behavior modification program was started.
According to our experience, there is a critical period involved with oral feeding during the first year of life. If not aware, children in transition for tube to oral feeding may display oral-motor, sensory and developmental feeding problems.
经胃造口术或鼻胃管进行的肠内喂养常用于婴幼儿，以确保足够的热量和营养摄入。如果我们没有意识到要尽快引入口服喂养，他们可能会发展出不良的喂养技能。
在1993 - 1996年期间，7名婴儿（平均年龄：6.7个月；标准差：3.6）出现了这个问题。其中6名使用鼻胃管，另1名使用胃造口术（经皮内镜下胃造口术）。在肠内喂养方案开始时，他们的体重z评分为 -3.32（标准差：-1.2），身高z评分为 -2.11（标准差：-0.51）。潜在疾病为胃食管反流（4例）、食管闭锁（1例）、短肠综合征（1例）和不明原因的厌食（1例）。
人工营养的平均时长为20个月（标准差：11.5），不过有2名患者仍接受夜间肠内滴注。6名患者在行为矫正方案开始后的3个月至2年内恢复了正常的喂养模式。
根据我们的经验，在生命的第一年存在一个与口服喂养相关的关键期。如果没有意识到这一点，从管饲过渡到口服喂养的儿童可能会出现口腔运动、感觉和发育性喂养问题。
